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Infectious Diseases

Updated 06 July 2020

Children are more resilient against Covid-19, study shows

A comprehensive analysis of more than 130 studies across 26 countries shows the affects of the new coronavirus on children - and it appears they are resilient.

  • Children are not immune to Covid-19, but most cases are mild.
  • A recent review analysed 131 studies of children with Covid-19.
  • The researchers found tha,t in most cases, children are better able to fight the disease than adults.

While infection with the new coronavirus is indeed occurring in children, studies have shown that they are less affected than adults. Researchers from the Long School of Medicine at the University of Texas Health Science Center in San Antonio recently published their findings on the topic, which show that children are more resilient against Covid-19, the disease caused by SARS-CoV-2.

The review covers 131 studies from children in 26 countries, published between 24 January and 14 May. It is the largest systematic review to date of children and young adults with Covid-19. It was published in EClinicalMedicine, a journal of The Lancet last week.

More on the study

"In the study, we report the most common symptoms, quantify laboratory findings and describe imaging characteristics of children with Covid-19," said study's senior author Dr Alvaro Moreira, who is an assistant professor of paediatrics at UT Health San Antonio and a fellowship-trained neonatologist.

The research team’s data included 7 780 patients who span the paediatric age spectrum. Their analysis revealed the following:

  • 19% of the paediatric population with Covid-19 had no symptoms;
  • 21% exhibited patchy lesions on lung X-rays;
  • 5.6% suffered from co-infections, such as flu, on top of Covid-19;
  • 3.3% were admitted to intensive care units;
  • Seven deaths were reported.

Covid-19 symptoms in children

According to the review, the most commonly experienced symptoms in children were similar to those in adults – fever and cough (59% and 56% respectively).

A past medical history was found in 233 patients, and among this group, 152 children had compromised immune systems or underlying respiratory or cardiac disease.

Moreira said that he and his team were surprised by the number of children who had presented with excellent outcomes, and provided reassuring comment that, although severe Covid-19 was seen in children, it only happened in very rare situations.

Laboratory measures that were consistently abnormal in paediatric Covid-19 patients included inflammatory markers such as creatine kinase, interleukin-6 and procalcitonin.

What the severe Covid-19 cases in children showed

According to the university’s news release on the study, a very small number of paediatric patients were found to have multisystem inflammatory syndrome, which paralleled the extreme forms of Covid-19 seen in adults.

Children with systemic inflammation had a significant decrease in the number of lymphocytes (one of the main types of immune cells in the body) in their blood, Moreira said, adding that in those who didn’t have the extreme form of Covid-19, 42% lymphocytes were found in their blood, compared to 11% with multisystem syndrome.

Nine patients also experienced kidney failure, and another nine liver failure, while 19 patients experienced shock. A total of 42 patients required mechanical ventilation.

Kidney failure was seen in nine paediatric patients, liver failure also in nine, and shock in 19. Mechanical ventilation was required by 42 patients.

According to Moreira, their review didn’t include the new surge of patients in New York, England and Italy, where specialists have started discovering multisystem inflammatory syndrome (MIS-C) in children. Formerly called paediatric inflammatory multisystem syndrome (PMS), it describes a new health condition seen in children who have been infected with the novel coronavirus. The Centers for Disease Control and Prevention (CDC) explains:

"We do not yet know what causes MIS-C. However, we know that many children with MIS-C had the virus that causes Covid-19, or had been around someone with Covid-19. MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care."

Health24 previously reported on this Kawasaki-like disease affecting children, but also noted that, while it can cause severe illness in paediatric patients, according to researchers, it is extremely rare.