Covid-19 infection in children may not start with a cough, but gastrointestinal symptoms with fever, according to a new report from China.
A team at Tongji Hospital, Wuhan, China, looked into the typical presentation in children.
They explain in the journal Frontiers yesterday (12 May) that: “Detailed information on the characteristics of Covid-19 in children is still scarce.”
Dr Wenbin Li and colleagues reported on five paediatric patients with non-respiratory symptoms who were hospitalised and found to be positive for Covid-19, in January.
The patients were aged two months to 5.6 years, and lived in Wuhan. Exposure to the virus was unsuspected in three of the patients.
Emergency treatment was needed for most, usually related to gastrointestinal conditions. Four of the five patients had a fever during the course of their disease, but one had no fever or cough.
The researchers report that a range of abnormal test results were seen among the patients, including lung inflammation in all.
“This case series is the first report to describe the clinical features of Covid-19 with non-respiratory symptoms as the first manifestation in children,” they write.
Dr Li said: "Most children are only mildly affected by Covid-19 and the few severe cases often have underlying health issues. It is easy to miss its diagnosis in the early stage, when a child has non-respiratory symptoms or suffers from another illness.
"Based on our experience of dealing with Covid-19, in regions where this virus is epidemic, children suffering from digestive tract symptoms, especially with fever and/or a history of exposure to this disease, should be suspected of being infected with this virus."
Li, W. et al. Clinical Characteristics of 5 COVID-19 Cases With Non-respiratory Symptoms as the First Manifestation in Children. Frontiers 12 May 2020; doi: 10.3389/fped.2020.00258
https://www.frontiersin.org/articles/10.3389/fped.2020.00258/full
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