This preliminary description of pediatric U.S. COVID-19 cases reports that relatively few children with COVID-19 are hospitalized, and fewer children than adults experience fever, cough, or shortness of breath. The report also describes severe outcomes reported in children, including three deaths.
Data from China suggest that pediatric COVID-19 cases might be less severe than cases in adults and that children (persons aged <18 years) might experience different symptoms than adults.
This report examines data on 149,760 laboratory-confirmed U.S. COVID-19 cases occurring during February 12–April 2, 2020 that were submitted through an electronic case-based COVID-19 surveillance database from 50 states, the District of Columbia, New York City, and four U.S territories.
Among 149,082 (99.6%) cases for which patient age was known, 2,572 (1.7%) occurred in children aged <18 years and 146,510 (98%) in adults aged ≥18 years, including 113,985 (76%) aged 18–64 years.
Among the 2,572 pediatric cases, 850 (33%) were reported from New York City; 584 (23%) from the rest of New York state; 393 (15%) from New Jersey; and the remaining 745 (29%) from other jurisdictions.
Among all 2,572 COVID-19 cases in children aged <18 years:
- The median age was 11 years (range 0–17 years)
- Nearly one third (813; 32%) occurred in children aged 15–17 years, followed by those in children aged 10–14 years (682; 27%).
- Among younger children, 398 (15%) occurred in children aged <1 year, 291 (11%) in children aged 1–4 years, and 388 (15%) in children aged 5–9 years.
- Among 2,490 pediatric COVID-19 cases for which sex was known, 1,408 (57%) occurred in males; among cases in adults aged ≥18 years for which sex was known, 53% (75,450 of 143,414) were in males.
- Among those with known information on each symptom, 56% of pediatric patients reported fever, 54% reported cough, and 13% reported shortness of breath, compared with 71%, 80%, and 43%, respectively, reporting these signs and symptoms among patients aged 18–64 years.
- Among 184 (7.2%) cases in children aged <18 years with known exposure information, 16 (9%) were associated with travel and 168 (91%) had exposure to a COVID-19 patient in the household or community.
Evidence suggests that pediatric COVID-19 patients might not have fever or cough. These findings are largely consistent with a report on pediatric COVID-19 patients aged <16 years in China, which found that only 41.5% of pediatric patients had fever, 48.5% had cough, and 1.8% were admitted to an ICU.
In summary, although most cases reported among children to date have not been severe, clinicians should maintain a high index of suspicion for COVID-19 infection in children and monitor for progression of illness, particularly among infants and children with underlying conditions.