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COVID-19 In Children: How They Contract Infection And What Are The Symptoms


As the coronavirus has infected more than a million people here in the U.S., more than 3 million people worldwide, there is still so little known about why children have largely been spared. Still, here in the nation's capital, doctors are warning that kids can get sick, even very sick.

Dr. Roberta DeBiasi is seeing that up close. She is division chief of infectious diseases at Children's National Hospital here in Washington, where they have seen more than 180 cases of coronavirus in children. Nearly 50 have been hospitalized.

ROBERTA DEBIASI: It is more than we've been expecting. You know, we were able to see that the cases that were happening on the West Coast confirmed what was happening in China in that there did not seem to be that many severely affected children. But what we have now seem to have experienced here on the East Coast - and particular, here in D.C. - is that we are seeing significant numbers of children hospitalized and even in critical care. We have a group that seems to be under a year of age that tend to be the kids that are not as ill and then this over-15 years of age and above that seem to be at a higher risk of admission - and particular, the over-15 that are more likely to be critically ill.

KELLY: So far, no deaths among children - is that right?


KELLY: Good. So when these children are coming in, what kind of symptoms are they reporting? What would prompt you to look at a child and think that kid needs a coronavirus test?

DEBIASI: Well, that has actually evolved over the course of this epidemic unfolding. So initially, we all used fever and cough as the main criteria. We now have patients who might have only fever or might only have a respiratory symptom. And we've even had some patients that don't have either one of those but are critically ill for another reason.

We've been very fortunate to have an in-house rapid test. We actually recently have been able to start screening all of our patients coming into the hospital because there are children that may be asymptomatically excreting the virus even if that's not the reason that they're in the hospital.

KELLY: Are certain children presenting as especially vulnerable? We've been tracking older adults that have underlying health conditions who do appear to be particularly vulnerable, whether they're suffering from diabetes or obesity or heart conditions, other things. Is that also true in children that those hospitalized might have a higher rate of underlying health conditions?

DEBIASI: We have looked at that in our interim analysis. And you know, what's interesting is about 30% of the kids don't actually have any underlying condition. But you know, the converse is true. The majority do. So 70% that are hospitalized or in critical care do have some underlying condition. Those have been our children with underlying neurologic disorders, like cerebral palsy or microcephaly or other neurologic disorders, as well as our patients who have congenital heart defects or some of our hematologic patients, like sickle cell or oncologic diagnoses. We have noticed that about 20% of the patients overall have asthma, but that does not seem to be a predictor for severity.

KELLY: What is your advice to parents if your child has a cough, has a low-grade fever, something that in ordinary times we might give a Tylenol and see if they feel better in the morning?

DEBIASI: Yeah, I think - you know, we really wanted to get out that the role of this virus in making some children very ill has been a bit underappreciated, and we think it's important for people to know that it can happen. But we don't want people to panic and think that every child now is going to be hospitalized or be critically ill because the vast, vast majority of them will have a minor illness. So we don't want the take-home to be panic. We do want the take-home to be that some children can get ill and that the pediatric institutions across the country are very ready and able to take care of these patients.

One other thing I would say is we also don't want people to walk away with the idea that we feel the impact on children is the same as adults because clearly, the amount of disease that we're seeing and the severity of disease in our older adults still far outweighs what we're seeing in the pediatric population. But there is a significant number of children that do end up in the hospital.

KELLY: That is Dr. Roberta DeBiasi. She's division chief of infectious diseases at Children's National Hospital in Washington.

Thank you.

DEBIASI: Thanks so much. Transcript provided by NPR, Copyright NPR.