Most kids with COVID-19 have mild cases and make a full recovery within weeks

Most children with COVID-19 last year had mild cases, didn't require medical care and made a full recovery within weeks of infection, according to new research.

Two studies led by the Murdoch Children's Research Institute (MCRI) in 2020 found children with COVID-19 experienced milder symptoms and less severe health complications compared to adults. 

Research, published in The Lancet Child & Adolescent Health journal, found of the 171 children aged under 18 years who tested positive for SARS-CoV-2 in Victoria in the seven months to October 28, 2020, 58 per cent had mild disease, 36 per cent were asymptomatic and 5 per cent had moderate disease.

MCRI Dr Shidan Tosif said all children recovered well and the common long-term symptoms of a cough and fatigue did not persist beyond eight weeks. 

"Unlike adults who can experience ongoing and serious health issues such as fatigue and lung problems, even with a mild case COVID-19, we are yet to see any long-term effects beyond two months in these children," he said.

MCRI Dr Laila Ibrahim said her study, published in The Medical Journal of Australia, which involved 16 hospitals across Australia, found children were less likely to be affected by COVID-19 in comparison with adults. 

The data, tracked through the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network, involved children who tested positive for SARS-CoV-2, in the seven months to September 30, 2020. Of 426 hospital presentations, 393 children tested positive for COVID-19 and most had mild cases that did not require medical intervention. Only one child had severe COVID-19 and another two children developed Paediatric Inflammatory Multisystem Syndrome, temporally associated with SARS-CoV-2 (PIMS-TS). 

The study found just 12 per cent were admitted to the hospital with 4 per cent treated at home remotely by a Hospital-in-the-Home program.

"Hospital admissions were generally brief, for observation or fluid rehydration," Dr Ibrahim said. "On average, children tested positive after two days of having symptoms such as fever, runny nose and a cough and many had household contacts who were also positive for COVID-19."

MCRI Professor Franz Babl said grouping patients in emergency departments into 'high risk' and 'low risk' categories based on symptoms may provide false reassurance.

"Our study showed that occasionally children with COVID-19 will be missed in the emergency department as some infants only had lethargy as a symptom," he said.

"There is also a high proportion of repeat presentations to the hospital. Ambulatory monitoring or the Hospital-in-the-Home program may reduce re-attendance to emergency departments and transmission risks."  

Researchers from The Royal Children's Hospital, the University of Melbourne, Sunshine Hospital, Austin Hospital, The Northern Hospital, Monash Children's Hospital, Casey Hospital, Dandenong Hospital, Box Hill Hospital, Angliss Hospital, Maroondah Hospital, The Children's Hospital at Westmead, John Hunter Hospital, Gold Coast University Hospital, Women's and Children's Hospital in Adelaide, Perth Children's Hospital, and University Hospital Geelong also contributed to one or both of the studies.

Publication: Daniela Say, Nigel Crawford, Sarah McNab, Danielle Wurzel, Andrew Steer and Shidan Tosif. 'Post-acute COVID-19 outcomes in children with mild and asymptomatic disease,' The Lancet Child & Adolescent Health. DOI: 10.1016/ S2352-4642(21)00124-3

Publication: Laila Ibrahim, Doris Tham, Vi Chong, Mark Corden, Simon Craig, Paul Buntine, Shefali Jani, Michael Zhang, Shane George, Amit Kochar, Sharon O'Brien, Karen Robins-Browne, Shidan Tosif, Andrew J Daley, Sarah McNab, Nigel W Crawford, Catherine L Wilson and Franz E Babl. 'COVID-19 in Children at 16 Australian Hospitals - a PREDICT Network Study,' The Medical Journal of Australia. DOI: 10.5694/mja2.51207

*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.

Available for interview:

Dr Shidan Tosif

Dr Laila Ibrahim

Associate Professor Nigel Crawford, MCRI Group Leader, SAFEVIC

Professor Franz Babl, MCRI Group Leader, Emergency

Media Contact:

Bridie Byrne

MCRI communications specialist

+613 9936 6211/ 0403 664 416

About MCRI

The Murdoch Children's Research Institute (MCRI) is the largest child health research institute in Australia committed to making discoveries and developing treatments to improve child and adolescent health in Australia and around the world. They are pioneering new treatments, trialling better vaccines and improving ways of diagnosing and helping sick babies, children and adolescents. It is one of the only research institutes in Australia to offer genetic testing to find answers for families of children with previously undiagnosed conditions.

Funding

LI is partly funded by a Clinician Scientist Fellowship (MCRI). FEB's time was part-funded by an NHMRC Practitioner Fellowship (GNT1124466) and by The Royal Children's Hospital Foundation. NC and SAEFVIC are supported by the Victorian Department of Health.