A palliative care physicians shares thoughts on an article on children and COVID-19 in China

Categories: Research.


Dr. Balu Natarajan, Chief Medical Officer with Seasons Healthcare Management, Inc. and President of Seasons Medical Group shares some thoughts on a recent letter, “SARS-CoV-2 Infection in Children,”  published in the New England Journal of Medicine (03/18/20). Dr. Natarajan agreed to share this with ehospiceUSA readers.

Hopeful news from China.

  • 1391 children tested for COVID-19.
  • 171 positive.
  • Only THREE needed ICU; all had major comorbidities highlighted below.
  • One death. 

The other 1388 appear to have thrived without any sustained issues.

Of the 1391 children assessed and tested from January 28 through February 26, 2020, a total of 171 (12.3%) were confirmed to have SARS-CoV-2 infection.

Demographic data and clinical features are summarized in Table 1. (Details of the laboratory and radiologic findings are provided in the Supplementary Appendix, available with the full text of this letter at NEJM.org.)

The median age of the infected children was 6.7 years. Fever was present in 41.5% of the children at any time during the illness. Other common signs and symptoms included cough and pharyngeal erythema. A total of 27 patients (15.8%) did not have any symptoms of infection or radiologic features of pneumonia. A total of 12 patients had radiologic features of pneumonia but did not have any symptoms of infection.

During the course of hospitalization, 3 patients required intensive care support and invasive mechanical ventilation; all had coexisting conditions (hydronephrosis, leukemia [for which the patient was receiving maintenance chemotherapy], and intussusception). Lymphopenia (lymphocyte count, <1.2×109 per liter) was present in 6 patients (3.5%). The most common radiologic finding was bilateral ground-glass opacity (32.7%).

 As of March 8, 2020, there was one death. A 10-month-old child with intussusception had multiorgan failure and died 4 weeks after admission. A total of 21 patients were in stable condition in the general wards, and 149 have been discharged from the hospital.


Visit the New England Journal of Medicine website to read the letter from physicians in China, “SARS-CoV-2 Infection in Children.” 


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