-   most children appear to have asymptomatic, mild, or moderate disease and recover within one to two weeks of disease onset
-  review of 7480 children <18 years of age with laboratory-confirmed COVID-19 infection, information about symptoms and severity was available for 1475
-   Among these, 15 percent of cases were asymptomatic, 42 percent were mild, 39 percent were moderate (eg, clinical or radiographic evidence of pneumonia without hypoxemia), 2 percent were severe (eg, dyspnea, central cyanosis, hypoxemia), and 0.7 percent were critical (eg, acute respiratory distress syndrome, respiratory failure, shock)
- A total of six deaths were reported

Frequency of severe disease in kids

-  Medical complexity
-  Congenital heart disease
-  Neurologic, genetic, or metabolic conditions
-  Chronic kidney disease

-  Immune compromise from solid organ transplant

 -  Obesity

-  Sickle cell disease

-  Type 2 diabetes mellitus
Cerebrovascular disease

-  Chronic pulmonary disease (eg, cystic fibrosis, moderate to severe asthma, pulmonary fibrosis)

-  Hypertension
-  immune compromise from hematopoietic cell transplant, primary immune deficiency, HIV, medications (eg, glucocorticoids)

-  Liver disease

-  Pregnancy

-  Smoking

-  Thalassemia

-  Type 1 diabetes mellitus

Risk factors for severe disease

 In observational studies, elevated inflammatory markers (eg, CRP, procalcitonin, interleukin 6, ferritin, D-dimer) at admission or during hospitalization have been associated with severe disease in children

Potential markers

MIS-C is a rare but serious condition associated with COVID-19 that has been reported in children from Europe and North America. The clinical features of MIS-C may be similar to those of Kawasaki disease, Kawasaki disease shock syndrome, and toxic shock syndrome

They include persistent fever, hypotension, gastrointestinal symptoms, rash, myocarditis, and laboratory findings associated with increased inflammation; respiratory symptoms may be lacking

Multisystem inflamatory syndrome in kids

-  Frequency of severe disease in kids
-  Risk factors for severe disease
-  potential markers
-  Multi-system inflammatory syndrome in kids

Ohio State University, Columbus

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

Deville, J. (2020, August 7). Coronavirus disease 2019 (COVID-19): Clinical manifestations and diagnosis in children. Retrieved August 13, 2020, from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-clinical-manifestations-and-diagnosis-in-children?topicRef=127535

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