Experts say children infected with COVID-19 may not show typical symptoms

A new study shows that children with COVID-19 may not display typical symptoms such as fever, cough and shortness of breath, therefore more screening and vigilance are required.

Service staff disinfecting hands of a girl in the classroomA new study shows that children with COVID-19 may not display typical symptoms such as fever, cough and shortness of breath, therefore more screening and vigilance are requirA new study published in the Nature Scientific Reports by University of Alabama at Birmingham researchers shows children with COVID-19 may not display typical symptoms such as fever, cough and shortness of breath, therefore more screening and vigilance are required.  

Researchers also found that children with COVID-19 may develop poor clinical outcomes such as requiring hospitalization, critical care services and mechanical ventilation.

Children and adolescents account for nearly 13 percent of all COVID-19 cases in the United States. This has resulted in the cautious reopening of schools and other educational institutions with a potentially heightened risk of transmission. There is a limited understanding of how children in the United States present with COVID-19 and the impact the infection has among children.

This study was aimed at better understanding the impact of COVID-19 on children, says Vibhu Parcha, M.D., a clinical research fellow in the Division of Cardiovascular Disease. Parcha and his team utilized the UAB Center for Clinical and Translational Science’s bioinformatics resources to assess the real-world data from multiple centers in the United States that are caring for COVID-19 patients.   

They analyzed the TriNetX COVID-19 research network database and identified nearly 12,000 pediatric COVID-19 patients. The team found that the most common symptoms included cough and difficulty breathing, gastrointestinal complaints such as nausea, vomiting, diarrhea and abdominal pain, and non-specific symptoms such as fever, tiredness, muscle pain, and disturbance of taste and smell.  

child covid.3Vibhu Parcha, M.D.
(Photography: Lexi Coon)
With the help of resources from UAB Medicine’s Informatics Institute led by James Cimino, M.D., the researchers at UAB have been able to investigate the impact of COVID-19 in infected children across various centers.

“During this study, we found that a majority of the population did not show any of the typical symptoms of COVID-19, including fever, cough and shortness of breath,” Parcha said. “While the rates of poor clinical outcomes are relatively lower in children when compared to adults, 5-6 percent still required hospitalization. Among those hospitalized, 18 percent required critical care and 4 percent needed a ventilator for breathing.”

Researchers also noted that non-Hispanic Black children and Hispanic children had a higher risk of hospitalization for COVID-19 compared to white children. However, the risk of requiring critical care or mechanical ventilation was similar among children from all racial groups.

“A key takeaway from this study is children with COVID-19 require enhanced screening and preventive measures that include low threshold for screening, ease of access to testing facilities and vaccination of eligible teenagers,” said Senior Author Pankaj Arora, M.D., a physician-scientist in the UAB Division of Cardiovascular Disease. “The racial disparities in health care were also evident in the higher risk of hospitalization among children from underserved minority populations. As vaccinations become available to teenagers, we need to ensure that we make the vaccine available to all eligible children, especially those from minority populations and high-risk households.”