Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

Incidence of COVID-19 in Children

By Landon Jones, MD and Richard M. Cantor, MD, FAAP, FACEP | on April 29, 2020 | 0 Comment
Kids korner
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version
Child getting a nasal swab

Editors’ Note: This article was accepted on April 6, 2020, and was accurate at that time. Because information about SARS-CoV-2 and COVID-19 is evolving rapidly, please verify these recommendations and information.

You Might Also Like
  • The Safety of Ibuprofen in Children with COVID-19
  • Loss of Taste and Smell Key COVID-19 Symptoms, App Study Finds
  • Blood Culture of Limited Value in Most Kids Hospitalized with Community-Acquired Pneumonia
Explore This Issue
ACEP Now: Vol 39 – No 05 – May 2020

What is the incidence of co-infection in children who are positive for COVID-19?

As of writing this column, the data are currently very limited regarding this topic as, overall, children appear to demonstrate milder signs of infection. A study by Xia et al retrospectively evaluated 20 hospitalized children in Wuhan Children’s Hospital in China over a 17-day period.1 Patient ages ranged from 1 day to 14 years, with a median age of 2 years. According to the authors, the total number of confirmed COVID-19 cases at this time in China was 37,251. The exact reasons for hospitalization of these children were not mentioned. There was a confirmed COVID-19 close contact in 13 of 20 (65 percent) of these pediatric hospitalized cases. Co-infection with another pathogen—either viral or bacterial—occurred in 8 of 20 (40 percent) of patients. The pathogens included cytomegalovirus (n=1), influenza A (n=1), influenza B (n=2), mycoplasma (n=4), and respiratory syncytial virus (n=1); one patient was, therefore, positive for COVID-19 and two additional pathogens. Importantly, most of the children did not demonstrate pulmonary physical exam findings (approximately 75 percent), suggesting that children are potential underrecognized carriers of this pathogen.

Regarding co-infection with coronavirus—while not specific to COVID-19—a study in Nepal by Uddin et al found a co-infection rate of 46 percent (137 of 296 patients). This was a prospective surveillance study over three years in children from birth to 6 months of age. In that population, the most common pathogens of co-infection were rhinovirus, bocavirus, and respiratory syncytial virus.

While it is reassuring that children appear to be less symptomatic than adults in COVID-19 infections, it is important to recognize that co-infections currently appear to be common.

Conclusion

While the data are very limited—especially in COVID-19-positive patients—it is important to recognize that co-infection does not appear to be uncommon and children may be minimally symptomatic with the disease. The best current co-infection estimate in hospitalized children is 40 percent.

References

  1. Xia W, Shao J, Guo Y et al. Clinical and CT features in pediatric patients with COVID-19 infection: different points from adults [published online ahead of print March 5, 2020]. Pediatr Pulmonol.
  2. Uddin SMI, Englund JA, Kuypers JY, et al. Burden and risk factors for coronavirus infections in infants in rural Nepal. Clin Infect Dis. 2018;67(10):1507-1514.

Pages: 1 2 | Single Page

Topics: coronavirusCOVID-19Pediatrics

Related

  • Case Report: When Syncope Gets Hairy

    June 17, 2025 - 0 Comment
  • Dr. Joe Sachs and “The Pitt” Are Redefining Public Health Education Through Storytelling

    June 11, 2025 - 0 Comment
  • June 2025 News from the College

    June 5, 2025 - 0 Comment

Current Issue

ACEP Now: June 2025 (Digital)

Read More

About the Authors

Landon Jones, MD

Dr. Jones is associate professor and pediatric emergency medicine fellowship director at the University of Kentucky Department of Emergency Medicine & Pediatrics in Lexington, Kentucky.

View this author's posts »

Richard M. Cantor, MD, FAAP, FACEP

Dr. Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Regional Poison Control Center at Upstate Medical University in Syracuse, New York.

View this author's posts »

No Responses to “Incidence of COVID-19 in Children”

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*

Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603