-  Fever, cough, or shortness of breath – 60 percent

-  Fever – 35 percent

-  Cough – 41 percent

-  Shortness of breath – 16 percent

-  Myalgia – 30 percent

-  Rhinorrhea – 8 percent

-  Headache – 42 percent

-  Nausea/vomiting – 10 percent

-  Abdominal pain – 8 percent

-  Diarrhea – 14 percent

-  Loss of smell or taste – 10 percent

Clinical findings on ages 10-19 yrs of age

-  Fever, cough, or shortness of breath – 63 percent

-  Fever – 46 percent

-  Cough – 37 percent

-  Shortness of breath – 7 percent

-  Myalgia – 10 percent

-  Rhinorrhea – 13 percent

-  Headache – 15 percent

-  Nausea/vomiting – 10 percent

-  Abdominal pain – 7 percent

-  Diarrhea – 14 percent

-  Loss of smell or taste – 1 percent

Clinical findings on ages 0-9 yrs of age

-  Gastrointestinal symptoms may occur without respiratory symptoms 
-  Diarrhea, vomiting, and abdominal pain are the most common gastrointestinal symptoms reported in children 
-  Gastrointestinal bleeding has been reported in adults but has not been reported in children
-  Reddish-purple nodules on the distal digits


Clinical manifestations

In a systematic review of 25 infants ≤3 months of age with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 5 were asymptomatic, 12 had mild symptoms, 5 had moderate symptoms, and 3 had severe symptoms.  Symptoms included fever, cough, dyspnea, vomiting, and feeding intolerance. Two infants were treated in the intensive care unit (ICU) and one required mechanical ventilation. Additional clinical findings include feeding difficulty and fever without an obvious source

Infants <12 months of age

-  The complete blood count was normal in most children; 17 percent had low white blood cell count and 13 percent had either neutropenia or lymphocytopenia; severe neutropenia has been described
-  Approximately one-third had elevated C-reactive protein (CRP; defined as >5 mg/L in most studies) or procalcitonin (defined as >0.5 ng/mL)
-  Elevated inflammatory markers and lymphocytopenia may indicate multisystem inflammatory syndrome in children (MIS-C)
-  Creatine kinase was elevated in 15 percent
-  Serum aminotransferases were elevated in 12 percent

Laboratory findings of children below 18 years of age

-  ages 0-9
-  ages 10-19
-  infants <12 months of age
-  Laboratory findings of children below 18 years of age

Ohio State University, Columbus

Developmental psychology researchers largely founded that learned experiences through environmental factors during early childhood engender the fundamentals for lifetime behavior and success as it is a crucial phase for cognitive, emotional and psychosocial skill development.  Closing of schools, parks, and playgrounds will disrupt children’s usual lifestyle and can potentially promote distress and confusion. Children are likely to become more demanding, having to cope up with these changes, and may exhibit impatience, annoyance and hostility, which in turn may cause them suffering from physical and mental violence by overly pressurized parents

Children

- Estimates predict increase in maternal and child mortality in low- and middle-income countries due to non-COVID-19 health care becoming scarce: estimated:
     - drop of 15% in coverage of life-saving essential health interventions for 6 months 
       in low- and middle-income countries is associated
     - 9.8% increase in mortality among children less than 5 years of age 
     - 8.3% increase in maternal mortality.

Long and Short Term Risks of COVID-19 on Childhood Development

In retrospective studies of transmission of SARS-CoV-2 from China, the household secondary attack rate among pediatric contacts has ranged from 4 to 7 percent.   In a review of cases from New York state (excluding New York City), the secondary attack rate among children <18 years was 27 percent. In utero and peripartum transmission and transmission through breast milk or during infant feeding. Cases of possible transmission from teachers or school staff to students and among students in the school setting have also been reported 

How do Children get Covid-19

Clinical findings in children of all ages

-  Outpatient criteria
-  Inpatient testing criteria
-  preoperative patients
-  Asymptotic individuals


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