After emerging data suggested that children infected with Covid-19 typically have no symptoms or a mild case of the virus, doctors at Ann & Robert H. Lurie Children’s Hospital of Chicago, USA, looked at 18 infants all under 90 days old who had tested positive for Covid-19.

They found that many of the infants were well, with little or no respiratory problems.

Most of the infants (14 out of 18) had a fever, while two had a cough as the only symptom.

One had choking associated with feeding and one child was asymptomatic and was screened because the parents had confirmed Covid-19.

Of the children, 50% (nine out of 18) were admitted to the hospital’s general inpatient service, although none required oxygen, respiratory support or intensive care.

Of those admitted, eight had fever, four had a cough or tachypnea (abnormally rapid breathing), and six had gastrointestinal (GI) symptoms including poor feeding, vomiting and diarrhoea, with respiratory tract symptoms of cough and congestion appearing before the onset of GI symptoms.

“It is unclear whether young infants with fever and a positive test for SARS-CoV-2 require hospital admission,” says lead author Dr Leena B Mithal.

“The decision to admit to the hospital is based on age, need for preemptive treatment of bacterial infection, clinical assessment, feeding tolerance and adequacy of follow-up.”

“While there is limited data on infants with Covid-19 from the United States, our findings suggest that these babies mostly have mild illness and may not be at higher risk of severe disease as initially reported from China,” says Dr Mithal, MD, MSCI, paediatric infectious diseases expert from Lurie Children’s and Assistant Professor of Paediatrics at Northwestern University Feinberg School of Medicine.

“Most of the infants in our study had fever, which suggests that for young infants being evaluated because of fever, Covid-19 may be an important cause, particularly in a region with widespread community activity.

However, evaluation for bacterial infection in young infants with fever remains important.”