Coronavirus Disease (COVID-19) in Children: What We Know So Far and What We Do Not

S Balasubramanian, N Rao*, Anu Goenka, Marion R Roderick, Athimalaipet V Ramanan

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

111 Citations (Scopus)
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Pediatric coronavirus disease – 19 (COVID-19) infection is relatively mild when compared to adults, and children are reported to have a better prognosis. Mortality in children appears rare. Clinical features of COVID-19 in children include fever and cough, but a large proportion of infected children appears to be asymptomatic and may contribute to transmission. It remains unclear why children and young adults are less severely affected than older individuals, but this might involve differences in immune system function in the elderly and/or differences in the expression/function of the cellular receptor for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) - Angiotensin converting enzyme 2 (ACE2). Laboratory findings and chest imaging may not be specific in children with COVID-19. Diagnosis is by Reverse transcriptase-Polymerase chain reaction (RT-PCR) testing of upper or lower respiratory tract secretions. This review additionally considers COVID-19 in immunosuppressed children, and also suggests a management algorithm for the few children who appear to present with life threatening infection, including the potential use of antiviral and immunomodulatory treatment. The most significant threat to global child health from SARS-CoV-2 is unlikely to be related to COVID 19 in children, but rather the socio-economic consequences of a prolonged pandemic.
Original languageEnglish
Pages (from-to)435–442
Number of pages8
JournalIndian Pediatrics
Early online date9 Apr 2020
Publication statusPublished - 15 May 2020

Structured keywords

  • Covid19


  • SARS-CoV-2
  • Pandemic
  • Management
  • Immunosuppressed
  • Paediatric
  • Coronavirus


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