Clinical Management of Children with an Epidemiological History of COVID-19: A Report on a Single Center of a General Hospital in Shenzhen, China

Background: Since December 2019, COVID-19 has been spreading from Wuhan, China to the nationwide and worldwide. Screening and management of children with respiratory symptoms and epidemiological histories of COVID-19 is of great significance in finding infected and asymptomatic cases. Methods: A retrospective case-series study was conducted from January 15 to February 28, 2020. Among the children coming to the hospital, those with epidemiological histories would be referred to the fever clinic. These children must undergo physical and auxiliary examinations to assess whether they have COVID-19. Information about other family members was obtained from the children’s medical records and telephone inquiries. Findings: A total of thirty-one children were triaged and assigned to the fever clinic. The interval from the last day of exposure to the date of symptom onset or SARS-CoV-2 nucleic acid test was three to eighteen days (median 8, IQR 6-12). Two cases were confirmed infection and one boy was tested suspicious positive of SARS-CoV-2 nucleic acid. One girl with fever and cough and a history of residence in Wuhan with typical chest image changes was considered as suspicious COVID-19. We found four families with infections and one family with suspected case and tracked these families. All these cases belonged to the groups of high or moderate epidemiological risk levels. Interpretation: The high or moderate risk level of the epidemiological histories and typical features of chest image are the most valuable information for the screening. SARS-CoV-2 nucleic acid test is recommended at least two times for the cases with the above characteristics. Timely detection of children with COVID-19, even those with invisible infection, is of positive significance for the epidemic control. Funding Statement: National Natural Science Foundation of China (No. 81971431 / H0422), Free Exploration Project of Shenzhen Science and Innovation Commission (No. JCYJ20170817100735621) and Opening Project of Shenzhen Institute of Synthetic Biology Innovation, Chinese Academy of Sciences (No.DWKF20190008). Declaration of Interests: The authors have indicated they have no potential conflicts of interest to disclose. Ethics Approval Statement: Data collection and analysis of cases and close contacts were determined by the National Health Commission of the People’s Republic of China to be part of a continuing public health outbreak investigation and were thus considered exempt from institutional review board approval.