This study provides an overview of the proportion of confirmed COVID-19 cases among those tested and the severity of the disease in children using a registry of tested cases from March 2, 2020, to March 16, 2020 by pediatricians in 30 secondary and tertiary hospitals in Madrid, Spain. 11.2% of children with symptoms who were screened for COVID-19 had positive test results.

Children were screened according to Spanish Public Health recommendations, which included those patients with a significant disease who were admitted, or likely to be admitted, at the time of evaluation according to the attending pediatrician or patients with signs or symptoms compatible with COVID-19 and the risk of complications due to baseline disease.

During the first 2 weeks of the epidemic in Madrid, Spain, 365 children were screened within the 30 hospitals. During the first week, 6 of 103 patients (5.8%) had positive test results. At the end of the second week, 41 of 365 patients (11.2%) had positive test results. By March 16, 2020, 41 of the 4695 confirmed cases (0.8%) in Madrid region were children younger than 18 years.

In addition:

• The median age of the tested patients was 3 years (interquartile range, 0.9-6 years; range, 0-15 years) and the median age of the patients with positive results was 1 year (interquartile range, 0.35-8.5 years; range 0-15 years).
• Twenty five of 41 children with confirmed COVID-19 (60%) were hospitalized, 4 of 41 (9.7%) were admitted to a pediatric intensive care unit (PICU), and 4 of 41 (9.7%) needed respiratory support beyond nasal prongs.
• Of these, 1 of 4 (25%) had only 1 previous condition (recurrent wheezing).
• No patients died.
• Initial syndromic diagnoses were upper respiratory tract infection (14 [34%]), fever without a source (11 [27%]), viral-like pneumonia (6 [15%]), bronchiolitis (5 [12%]), gastroenteritis or vomiting (2 [5%]), bacterial-like pneumonia (2 [5%]), and asthma flare (1 [2%]).
• Two patients (5%) had a coinfection with influenza B.