This expert and narrative review describes key epidemiological and clinical features of COVID-19 infections within children, neonates, and pregnant mothers.
- Overall, 83% of the children had a positive contact history, mostly with family members.
- The incubation period varied between 2 and 25 days with a mean of 7 days.
- The virus could be isolated from nasopharyngeal secretions for up to 22 days and from stool for more than 30 days. Co-infections were reported in up to 79% of children (mainly mycoplasma and influenza).
- Up to 35% of children were asymptomatic.
- The most common symptoms were cough (48%; range 19%–100%), fever (42%; 11%–100%) and pharyngitis (30%; 11%–100%). Further symptoms were nasal congestion, rhinorrhea, tachypnea, wheezing, diarrhea, vomiting, headache and fatigue.
- Laboratory test parameters were only minimally altered.
- Radiologic findings were unspecific and included unilateral or bilateral infiltrates with, in some cases, ground-glass opacities or consolidation with a surrounding halo sign.
- Children rarely needed admission to intensive care units (3%), and to date, only a small number of deaths have been reported in children globally.
- Two mothers (3%) were admitted to intensive care unit. Fetal distress was reported in 30% of pregnancies.
- Neonatal complications included respiratory distress or pneumonia (18%), disseminated intravascular coagulation (3%), asphyxia (2%) and 2 perinatal deaths.
- Four neonates (3 with pneumonia) have been reported to be SARS-CoV-2 positive despite strict infection control and prevention procedures during delivery and separation of mother and neonates, meaning vertical transmission could not be excluded.