As the spread of the novel coronavirus disease (COVID-19) accelerates, cases of children infected with COVID-19 are of great concern to the public. Although previous studies show the coronavirus raging across China tended to tread gently with children, experts suggest the risks are unexpected, and the prevention and protection of children should not be ignored.  

What are the risks for children infected with COVID-19? This is the pressing question for pediatric infectious disease specialists and concerned parents alike. 

Symptoms of children with COVID-19 are atypical and not be easily diagnosed 

Wuhan Children's Hospital is the only designated hospital for children in Wuhan, where most of the confirmed and suspected children are received and treated. Until March 8, the hospital received 683 confirmed and suspected cases of COVID-19, and 419 cases recovered and discharged from hospital.  

According to Lu Xiaoxia, director of the respiratory department of Wuhan Children's Hospital, the current situation shows children appear to have milder clinical symptoms, severe cases among children account for about five percent of the total confirmed cases.  

Meanwhile, several studies revealed that compared to the infected adults, symptoms of some infected children or new-born children are atypical, often manifesting like vomiting, diarrhea and other gastrointestinal symptoms, or only tachypnea.  

In addition, as children are less frequently symptomatic and have less severe symptoms they are tested less, which might lead to an underestimate of the true numbers infected.  

However, it should not be ignored that there are also a few severe COVID-19 cases of children even new-born children. On March 12, a joint team from Wuhan University, Fudan University and Tongji Medical College of Huazhong University of Science and Technology published a study on NEJM, saying that COVID-19 could cause moderate to severe respiratory disease in some children. 

Another noteworthy situation is that children infected with COVID-19 usually have long period of intestinal detoxification, which could lead to the virus being transmitted through feces. But whether it is infectious still needs to be further studied. 

Since some infected children presented gastrointestinal symptoms, such as diarrhea, doctors, medical workers, and cleaners should be careful in how they deal with urine and feces because it increases the level of contamination and risks. 

Family and community gatherings pose risks and are at risk

Many researchers stressed that children are also susceptible to COVID-19, and most are caused by family and community gatherings. 

Some experts noted that if parents fail to detect mild symptoms in time, it might cause a virus outbreak in the community.   

Considering that detecting children with COVID-19 is harder, and in a bid to avoid the spread of COVID-19 due to the missed diagnosis, it's of great importance to establish targeted screening measures. In addition, many hospitals call for using image features to further identify children with milder symptoms as well as no symptoms. 

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