CC BY 4.0 · Journal of Child Science 2020; 10(01): e137-e140
DOI: 10.1055/s-0040-1717077
Review Article

Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

1  Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt
Nada M. Abdel-Aziz
2  Faculty of Dentistry, October University of Modern Science and Arts (MSA), October City, Egypt
Dina M. Abdel-Aziz
3  Faculty of Medicine, Misr University for Science and Technology (MUST), Misr, Egypt
Noha Azab
4  Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
› Author Affiliations
Funding None.


The clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

Publication History

Received: 24 July 2020

Accepted: 20 August 2020

Publication Date:
15 October 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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