First month of data shows children at low risk of COVID-19 infection, no hospitalizations

In the first 30 days since seeing their first patient, the number of children testing positive to COVID-19 at an Australian tertiary paediatric hospital has been low and none who contracted the virus required in-hospital treatment, according to a new study.

The research, led by the Murdoch Children’s Research Institute (MCRI) and published in Emergency Medicine Australasia, is the first Australian study to examine the rate of COVID-19 in children and adolescents presenting to an Australian hospital.

MCRI’s Dr Laila Ibrahim said the study was reassuring for parents with children presenting to hospital with the usual childhood acute respiratory illnesses such as asthma, croup and bronchiolitis, that at this time it was very unlikely they have COVID-19.

Dr Ibrahim said parents should also not delay seeking hospital treatment for their children due to fears of contracting the virus.

“The data shows that many worried parents are coming to the hospital when their child has a cough or fever, but of over 400 children tested, only four tested positive to COVID-19,” she said.

“This study shows that Australia has responded extremely well to the threat. Hospitals are a safe place with a very low risk of being exposed to COVID-19, and community transmission over the course of the study period was also low.”

But Dr Ibrahim said despite the low number of cases to date locally, overseas data had shown that children could still become severely unwell with COVID-19 and there shouldn’t be complacency.

The four-week study included 434 patients, aged 0-18 years, who presented with COVID-19 symptoms to the emergency department or the respiratory infection clinic of a major paediatric hospital. The study started after the first positive case was confirmed at the hospital on March 21.

None of the four positive children were admitted to hospital, developed severe symptoms or had significant additional medical conditions. They all recovered within two weeks after experiencing mild upper respiratory symptoms like a sore throat. Only one was managed under the Hospital-in-the-Home program.

MCRI Dr Shidan Tosif, who oversaw follow-up with the families, said the data highlighted the success of outpatient management for COVID-19 positive patients.

“The patients were not admitted to hospital after having a clinical assessment, knowing that their COVID-19 test may later return a positive result,” he said. “We were confident that treating children with COVID-19 in the home was the best option.”

Dr Tosif said so far there were no reported cases of the multisystem inflammatory syndrome similar to Kawasaki disease that have been described overseas.

“Australians have participated so well in physical distancing measures that we expect to see no or low numbers of patients with this rare complication, even though we are watching very, very carefully for it,” he said.

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Researchers from the University of Melbourne, The Royal Children’s Hospital and Soonchunhyang University Cheonan Hospital in South Korea also contributed to the findings. The research study was approved by the institutional Human Research Ethics Committee.

Publication: Laila F Ibrahim, Shidan Tosif, Sarah McNab, Samantha Hall, Hyun Jung Lee, Stuart Lewena, Nigel Crawford, Andrew Steer, Penelope A Bryant and Franz E Babl. ‘SARS-COV-2 Testing and Outcomes in the First 30 Days after the First Case of COVID-19 at an Australian Children’s Hospital,’ Emergency Medicine Australasia. DOI: 10.1111/1742-6723.13550

Available for interview:

Dr Laila Ibrahim

Dr Shidan Tosif