Clinical Characteristics and Viral RNA Detection in Children With Coronavirus Disease 2019 in the Republic of Korea.
Identifieur interne : 000D60 ( Main/Corpus ); précédent : 000D59; suivant : 000D61Clinical Characteristics and Viral RNA Detection in Children With Coronavirus Disease 2019 in the Republic of Korea.
Auteurs : Mi Seon Han ; Eun Hwa Choi ; Sung Hee Chang ; Byoung-Lo Jin ; Eun Joo Lee ; Baek Nam Kim ; Min Kyoung Kim ; Kihyun Doo ; Ju-Hee Seo ; Yae-Jean Kim ; Yeo Jin Kim ; Ji Young Park ; Sun Bok Suh ; Hyunju Lee ; Eun Young Cho ; Dong Hyun Kim ; Jong Min Kim ; Hye Young Kim ; Su Eun Park ; Joon Kee Lee ; Dae Sun Jo ; Seung-Man Cho ; Jae Hong Choi ; Kyo Jin Jo ; Young June Choe ; Ki Hwan Kim ; Jong-Hyun KimSource :
- JAMA pediatrics [ 2168-6211 ] ; 2021.
English descriptors
- KwdEn :
- Adolescent (MeSH), Age Factors (MeSH), COVID-19 (complications), COVID-19 (diagnosis), COVID-19 Nucleic Acid Testing (MeSH), Child (MeSH), Child, Preschool (MeSH), Female (MeSH), Humans (MeSH), Infant (MeSH), Infant, Newborn (MeSH), Male (MeSH), RNA, Viral (isolation & purification), Republic of Korea (MeSH), Reverse Transcriptase Polymerase Chain Reaction (MeSH), SARS-CoV-2 (isolation & purification), Symptom Assessment (MeSH).
- MESH :
- chemical , isolation & purification : RNA, Viral.
- geographic : Republic of Korea.
- complications : COVID-19.
- diagnosis : COVID-19.
- isolation & purification : SARS-CoV-2.
- Adolescent, Age Factors, COVID-19 Nucleic Acid Testing, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Reverse Transcriptase Polymerase Chain Reaction, Symptom Assessment.
Abstract
Importance
There is limited information describing the full spectrum of coronavirus disease 2019 (COVID-19) and the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in children.
Objective
To analyze the full clinical course and the duration of SARS-CoV-2 RNA detectability in children confirmed with COVID-19 in the Republic of Korea, where rigorous public health interventions have been implemented.
Design, Setting, and Participants
This case series of children with COVID-19 was conducted in 20 hospitals and 2 nonhospital isolation facilities across the country from February 18, 2020, to March 31, 2020. Children younger than 19 years who had COVID-19 were included.
Exposures
Confirmed COVID-19, detected via SARS-CoV-2 RNA in a combined nasopharyngeal and oropharyngeal swab or sputum by real-time reverse transcription-polymerase chain reaction.
Main Outcomes and Measures
Clinical manifestations during the observation period, including the time and duration of symptom occurrence. The duration of SARS-CoV-2 RNA detection was also analyzed.
Results
A total of 91 children with COVID-19 were included (median [range] age, 11 [0-18] years; 53 boys [58%]). Twenty children (22%) were asymptomatic during the entire observation period. Among 71 symptomatic cases, 47 children (66%) had unrecognized symptoms before diagnosis, 18 (25%) developed symptoms after diagnosis, and only 6 (9%) were diagnosed at the time of symptom onset. Twenty-two children (24%) had lower respiratory tract infections. The mean (SD) duration of the presence of SARS-CoV-2 RNA in upper respiratory samples was 17.6 (6.7) days. Virus RNA was detected for a mean (SD) of 14.1 (7.7) days in asymptomatic individuals. There was no difference in the duration of virus RNA detection between children with upper respiratory tract infections and lower respiratory tract infections (mean [SD], 18.7 [5.8] days vs 19.9 [5.6] days; P = .54). Fourteen children (15%) were treated with lopinavir-ritonavir and/or hydroxychloroquine. All recovered, without any fatal cases.
Conclusions and Relevance
In this case series study, inapparent infections in children may have been associated with silent COVID-19 transmission in the community. Heightened surveillance using laboratory screening will allow detection in children with unrecognized SARS-CoV-2 infection.
DOI: 10.1001/jamapediatrics.2020.3988
PubMed: 32857112
PubMed Central: PMC7455883
Links to Exploration step
pubmed:32857112Le document en format XML
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Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Jin, Byoung Lo" sort="Jin, Byoung Lo" uniqKey="Jin B" first="Byoung-Lo" last="Jin">Byoung-Lo Jin</name><affiliation><nlm:affiliation>Department of Pediatrics, Hongseong Medical Center, Hongseong, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Eun Joo" sort="Lee, Eun Joo" uniqKey="Lee E" first="Eun Joo" last="Lee">Eun Joo Lee</name><affiliation><nlm:affiliation>Department of Pediatrics, Seongnam Citizens Medical Center, Seongnam, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Baek Nam" sort="Kim, Baek Nam" uniqKey="Kim B" first="Baek Nam" last="Kim">Baek Nam Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Gyeonggi Provincial Medical Center Ansung Hospital, Ansung, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Min Kyoung" sort="Kim, Min Kyoung" uniqKey="Kim M" first="Min Kyoung" last="Kim">Min Kyoung Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Seonam Hospital, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Doo, Kihyun" sort="Doo, Kihyun" uniqKey="Doo K" first="Kihyun" last="Doo">Kihyun Doo</name><affiliation><nlm:affiliation>Department of Pediatrics, Gyeonggi Provincial Medical Center Icheon Hospital, Icheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Seo, Ju Hee" sort="Seo, Ju Hee" uniqKey="Seo J" first="Ju-Hee" last="Seo">Ju-Hee Seo</name><affiliation><nlm:affiliation>Department of Pediatrics, Dankook University Hospital, Cheonan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Yae Jean" sort="Kim, Yae Jean" uniqKey="Kim Y" first="Yae-Jean" last="Kim">Yae-Jean Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Yeo Jin" sort="Kim, Yeo Jin" uniqKey="Kim Y" first="Yeo Jin" last="Kim">Yeo Jin Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Masan Medical Center, Changwon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Park, Ji Young" sort="Park, Ji Young" uniqKey="Park J" first="Ji Young" last="Park">Ji Young Park</name><affiliation><nlm:affiliation>Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Suh, Sun Bok" sort="Suh, Sun Bok" uniqKey="Suh S" first="Sun Bok" last="Suh">Sun Bok Suh</name><affiliation><nlm:affiliation>Department of Pediatrics, Busan Medical Center, Busan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Hyunju" sort="Lee, Hyunju" uniqKey="Lee H" first="Hyunju" last="Lee">Hyunju Lee</name><affiliation><nlm:affiliation>Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Cho, Eun Young" sort="Cho, Eun Young" uniqKey="Cho E" first="Eun Young" last="Cho">Eun Young Cho</name><affiliation><nlm:affiliation>Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Dong Hyun" sort="Kim, Dong Hyun" uniqKey="Kim D" first="Dong Hyun" last="Kim">Dong Hyun Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Inha University Hospital, Incheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Jong Min" sort="Kim, Jong Min" uniqKey="Kim J" first="Jong Min" last="Kim">Jong Min Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Myongji Hospital, Goyang, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Hye Young" sort="Kim, Hye Young" uniqKey="Kim H" first="Hye Young" last="Kim">Hye Young Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Pusan National University Hospital, Busan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Park, Su Eun" sort="Park, Su Eun" uniqKey="Park S" first="Su Eun" last="Park">Su Eun Park</name><affiliation><nlm:affiliation>Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Joon Kee" sort="Lee, Joon Kee" uniqKey="Lee J" first="Joon Kee" last="Lee">Joon Kee Lee</name><affiliation><nlm:affiliation>Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Jo, Dae Sun" sort="Jo, Dae Sun" uniqKey="Jo D" first="Dae Sun" last="Jo">Dae Sun Jo</name><affiliation><nlm:affiliation>Department of Pediatrics, Jeonbuk National University Medical School, Jeonju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Cho, Seung Man" sort="Cho, Seung Man" uniqKey="Cho S" first="Seung-Man" last="Cho">Seung-Man Cho</name><affiliation><nlm:affiliation>Department of Pediatrics, Dongguk University College of Medicine, Gyeongju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Choi, Jae Hong" sort="Choi, Jae Hong" uniqKey="Choi J" first="Jae Hong" last="Choi">Jae Hong Choi</name><affiliation><nlm:affiliation>Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Jo, Kyo Jin" sort="Jo, Kyo Jin" uniqKey="Jo K" first="Kyo Jin" last="Jo">Kyo Jin Jo</name><affiliation><nlm:affiliation>Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Choe, Young June" sort="Choe, Young June" uniqKey="Choe Y" first="Young June" last="Choe">Young June Choe</name><affiliation><nlm:affiliation>Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Ki Hwan" sort="Kim, Ki Hwan" uniqKey="Kim K" first="Ki Hwan" last="Kim">Ki Hwan Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Jong Hyun" sort="Kim, Jong Hyun" uniqKey="Kim J" first="Jong-Hyun" last="Kim">Jong-Hyun Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, St Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:32857112</idno><idno type="pmid">32857112</idno><idno type="doi">10.1001/jamapediatrics.2020.3988</idno><idno type="pmc">PMC7455883</idno><idno type="wicri:Area/Main/Corpus">000D60</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000D60</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical Characteristics and Viral RNA Detection in Children With Coronavirus Disease 2019 in the Republic of Korea.</title><author><name sortKey="Han, Mi Seon" sort="Han, Mi Seon" uniqKey="Han M" first="Mi Seon" last="Han">Mi Seon Han</name><affiliation><nlm:affiliation>Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Choi, Eun Hwa" sort="Choi, Eun Hwa" uniqKey="Choi E" first="Eun Hwa" last="Choi">Eun Hwa Choi</name><affiliation><nlm:affiliation>Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Chang, Sung Hee" sort="Chang, Sung Hee" uniqKey="Chang S" first="Sung Hee" last="Chang">Sung Hee Chang</name><affiliation><nlm:affiliation>Department of Pediatrics, Seoul Medical Center, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Jin, Byoung Lo" sort="Jin, Byoung Lo" uniqKey="Jin B" first="Byoung-Lo" last="Jin">Byoung-Lo Jin</name><affiliation><nlm:affiliation>Department of Pediatrics, Hongseong Medical Center, Hongseong, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Eun Joo" sort="Lee, Eun Joo" uniqKey="Lee E" first="Eun Joo" last="Lee">Eun Joo Lee</name><affiliation><nlm:affiliation>Department of Pediatrics, Seongnam Citizens Medical Center, Seongnam, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Baek Nam" sort="Kim, Baek Nam" uniqKey="Kim B" first="Baek Nam" last="Kim">Baek Nam Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Gyeonggi Provincial Medical Center Ansung Hospital, Ansung, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Min Kyoung" sort="Kim, Min Kyoung" uniqKey="Kim M" first="Min Kyoung" last="Kim">Min Kyoung Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Seonam Hospital, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Doo, Kihyun" sort="Doo, Kihyun" uniqKey="Doo K" first="Kihyun" last="Doo">Kihyun Doo</name><affiliation><nlm:affiliation>Department of Pediatrics, Gyeonggi Provincial Medical Center Icheon Hospital, Icheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Seo, Ju Hee" sort="Seo, Ju Hee" uniqKey="Seo J" first="Ju-Hee" last="Seo">Ju-Hee Seo</name><affiliation><nlm:affiliation>Department of Pediatrics, Dankook University Hospital, Cheonan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Yae Jean" sort="Kim, Yae Jean" uniqKey="Kim Y" first="Yae-Jean" last="Kim">Yae-Jean Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Yeo Jin" sort="Kim, Yeo Jin" uniqKey="Kim Y" first="Yeo Jin" last="Kim">Yeo Jin Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Masan Medical Center, Changwon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Park, Ji Young" sort="Park, Ji Young" uniqKey="Park J" first="Ji Young" last="Park">Ji Young Park</name><affiliation><nlm:affiliation>Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Suh, Sun Bok" sort="Suh, Sun Bok" uniqKey="Suh S" first="Sun Bok" last="Suh">Sun Bok Suh</name><affiliation><nlm:affiliation>Department of Pediatrics, Busan Medical Center, Busan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Hyunju" sort="Lee, Hyunju" uniqKey="Lee H" first="Hyunju" last="Lee">Hyunju Lee</name><affiliation><nlm:affiliation>Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Cho, Eun Young" sort="Cho, Eun Young" uniqKey="Cho E" first="Eun Young" last="Cho">Eun Young Cho</name><affiliation><nlm:affiliation>Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Dong Hyun" sort="Kim, Dong Hyun" uniqKey="Kim D" first="Dong Hyun" last="Kim">Dong Hyun Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Inha University Hospital, Incheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Jong Min" sort="Kim, Jong Min" uniqKey="Kim J" first="Jong Min" last="Kim">Jong Min Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Myongji Hospital, Goyang, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Hye Young" sort="Kim, Hye Young" uniqKey="Kim H" first="Hye Young" last="Kim">Hye Young Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Pusan National University Hospital, Busan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Park, Su Eun" sort="Park, Su Eun" uniqKey="Park S" first="Su Eun" last="Park">Su Eun Park</name><affiliation><nlm:affiliation>Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Joon Kee" sort="Lee, Joon Kee" uniqKey="Lee J" first="Joon Kee" last="Lee">Joon Kee Lee</name><affiliation><nlm:affiliation>Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Jo, Dae Sun" sort="Jo, Dae Sun" uniqKey="Jo D" first="Dae Sun" last="Jo">Dae Sun Jo</name><affiliation><nlm:affiliation>Department of Pediatrics, Jeonbuk National University Medical School, Jeonju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Cho, Seung Man" sort="Cho, Seung Man" uniqKey="Cho S" first="Seung-Man" last="Cho">Seung-Man Cho</name><affiliation><nlm:affiliation>Department of Pediatrics, Dongguk University College of Medicine, Gyeongju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Choi, Jae Hong" sort="Choi, Jae Hong" uniqKey="Choi J" first="Jae Hong" last="Choi">Jae Hong Choi</name><affiliation><nlm:affiliation>Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Jo, Kyo Jin" sort="Jo, Kyo Jin" uniqKey="Jo K" first="Kyo Jin" last="Jo">Kyo Jin Jo</name><affiliation><nlm:affiliation>Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Choe, Young June" sort="Choe, Young June" uniqKey="Choe Y" first="Young June" last="Choe">Young June Choe</name><affiliation><nlm:affiliation>Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Ki Hwan" sort="Kim, Ki Hwan" uniqKey="Kim K" first="Ki Hwan" last="Kim">Ki Hwan Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Jong Hyun" sort="Kim, Jong Hyun" uniqKey="Kim J" first="Jong-Hyun" last="Kim">Jong-Hyun Kim</name><affiliation><nlm:affiliation>Department of Pediatrics, St Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.</nlm:affiliation></affiliation></author></analytic><series><title level="j">JAMA pediatrics</title><idno type="eISSN">2168-6211</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Age Factors (MeSH)</term><term>COVID-19 (complications)</term><term>COVID-19 (diagnosis)</term><term>COVID-19 Nucleic Acid Testing (MeSH)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Infant (MeSH)</term><term>Infant, Newborn (MeSH)</term><term>Male (MeSH)</term><term>RNA, Viral (isolation & purification)</term><term>Republic of Korea (MeSH)</term><term>Reverse Transcriptase Polymerase Chain Reaction (MeSH)</term><term>SARS-CoV-2 (isolation & purification)</term><term>Symptom Assessment (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="isolation & purification" xml:lang="en"><term>RNA, Viral</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Republic of Korea</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Age Factors</term><term>COVID-19 Nucleic Acid Testing</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term><term>Reverse Transcriptase Polymerase Chain Reaction</term><term>Symptom Assessment</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Importance</b></p><p>There is limited information describing the full spectrum of coronavirus disease 2019 (COVID-19) and the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in children.</p></div><div type="abstract" xml:lang="en"><p><b>Objective</b></p><p>To analyze the full clinical course and the duration of SARS-CoV-2 RNA detectability in children confirmed with COVID-19 in the Republic of Korea, where rigorous public health interventions have been implemented.</p></div><div type="abstract" xml:lang="en"><p><b>Design, Setting, and Participants</b></p><p>This case series of children with COVID-19 was conducted in 20 hospitals and 2 nonhospital isolation facilities across the country from February 18, 2020, to March 31, 2020. Children younger than 19 years who had COVID-19 were included.</p></div><div type="abstract" xml:lang="en"><p><b>Exposures</b></p><p>Confirmed COVID-19, detected via SARS-CoV-2 RNA in a combined nasopharyngeal and oropharyngeal swab or sputum by real-time reverse transcription-polymerase chain reaction.</p></div><div type="abstract" xml:lang="en"><p><b>Main Outcomes and Measures</b></p><p>Clinical manifestations during the observation period, including the time and duration of symptom occurrence. The duration of SARS-CoV-2 RNA detection was also analyzed.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>A total of 91 children with COVID-19 were included (median [range] age, 11 [0-18] years; 53 boys [58%]). Twenty children (22%) were asymptomatic during the entire observation period. Among 71 symptomatic cases, 47 children (66%) had unrecognized symptoms before diagnosis, 18 (25%) developed symptoms after diagnosis, and only 6 (9%) were diagnosed at the time of symptom onset. Twenty-two children (24%) had lower respiratory tract infections. The mean (SD) duration of the presence of SARS-CoV-2 RNA in upper respiratory samples was 17.6 (6.7) days. Virus RNA was detected for a mean (SD) of 14.1 (7.7) days in asymptomatic individuals. There was no difference in the duration of virus RNA detection between children with upper respiratory tract infections and lower respiratory tract infections (mean [SD], 18.7 [5.8] days vs 19.9 [5.6] days; P = .54). Fourteen children (15%) were treated with lopinavir-ritonavir and/or hydroxychloroquine. All recovered, without any fatal cases.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions and Relevance</b></p><p>In this case series study, inapparent infections in children may have been associated with silent COVID-19 transmission in the community. Heightened surveillance using laboratory screening will allow detection in children with unrecognized SARS-CoV-2 infection.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32857112</PMID><DateCompleted><Year>2021</Year><Month>01</Month><Day>13</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>13</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">2168-6211</ISSN><JournalIssue CitedMedium="Internet"><Volume>175</Volume><Issue>1</Issue><PubDate><Year>2021</Year><Month>01</Month><Day>01</Day></PubDate></JournalIssue><Title>JAMA pediatrics</Title><ISOAbbreviation>JAMA Pediatr</ISOAbbreviation></Journal><ArticleTitle>Clinical Characteristics and Viral RNA Detection in Children With Coronavirus Disease 2019 in the Republic of Korea.</ArticleTitle><Pagination><MedlinePgn>73-80</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1001/jamapediatrics.2020.3988</ELocationID><Abstract><AbstractText Label="Importance">There is limited information describing the full spectrum of coronavirus disease 2019 (COVID-19) and the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in children.</AbstractText><AbstractText Label="Objective">To analyze the full clinical course and the duration of SARS-CoV-2 RNA detectability in children confirmed with COVID-19 in the Republic of Korea, where rigorous public health interventions have been implemented.</AbstractText><AbstractText Label="Design, Setting, and Participants">This case series of children with COVID-19 was conducted in 20 hospitals and 2 nonhospital isolation facilities across the country from February 18, 2020, to March 31, 2020. Children younger than 19 years who had COVID-19 were included.</AbstractText><AbstractText Label="Exposures">Confirmed COVID-19, detected via SARS-CoV-2 RNA in a combined nasopharyngeal and oropharyngeal swab or sputum by real-time reverse transcription-polymerase chain reaction.</AbstractText><AbstractText Label="Main Outcomes and Measures">Clinical manifestations during the observation period, including the time and duration of symptom occurrence. The duration of SARS-CoV-2 RNA detection was also analyzed.</AbstractText><AbstractText Label="Results">A total of 91 children with COVID-19 were included (median [range] age, 11 [0-18] years; 53 boys [58%]). Twenty children (22%) were asymptomatic during the entire observation period. Among 71 symptomatic cases, 47 children (66%) had unrecognized symptoms before diagnosis, 18 (25%) developed symptoms after diagnosis, and only 6 (9%) were diagnosed at the time of symptom onset. Twenty-two children (24%) had lower respiratory tract infections. The mean (SD) duration of the presence of SARS-CoV-2 RNA in upper respiratory samples was 17.6 (6.7) days. Virus RNA was detected for a mean (SD) of 14.1 (7.7) days in asymptomatic individuals. There was no difference in the duration of virus RNA detection between children with upper respiratory tract infections and lower respiratory tract infections (mean [SD], 18.7 [5.8] days vs 19.9 [5.6] days; P = .54). Fourteen children (15%) were treated with lopinavir-ritonavir and/or hydroxychloroquine. All recovered, without any fatal cases.</AbstractText><AbstractText Label="Conclusions and Relevance">In this case series study, inapparent infections in children may have been associated with silent COVID-19 transmission in the community. Heightened surveillance using laboratory screening will allow detection in children with unrecognized SARS-CoV-2 infection.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Han</LastName><ForeName>Mi Seon</ForeName><Initials>MS</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Choi</LastName><ForeName>Eun Hwa</ForeName><Initials>EH</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chang</LastName><ForeName>Sung Hee</ForeName><Initials>SH</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Seoul Medical Center, Seoul, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jin</LastName><ForeName>Byoung-Lo</ForeName><Initials>BL</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Hongseong Medical Center, Hongseong, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Eun Joo</ForeName><Initials>EJ</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Seongnam Citizens Medical Center, Seongnam, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Baek Nam</ForeName><Initials>BN</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Gyeonggi Provincial Medical Center Ansung Hospital, Ansung, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Min Kyoung</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Seonam Hospital, Seoul, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Doo</LastName><ForeName>Kihyun</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Gyeonggi Provincial Medical Center Icheon Hospital, Icheon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seo</LastName><ForeName>Ju-Hee</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Dankook University Hospital, Cheonan, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Yae-Jean</ForeName><Initials>YJ</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Yeo Jin</ForeName><Initials>YJ</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Masan Medical Center, Changwon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Park</LastName><ForeName>Ji Young</ForeName><Initials>JY</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Suh</LastName><ForeName>Sun Bok</ForeName><Initials>SB</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Busan Medical Center, Busan, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Hyunju</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cho</LastName><ForeName>Eun Young</ForeName><Initials>EY</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Dong Hyun</ForeName><Initials>DH</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Inha University Hospital, Incheon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Jong Min</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Myongji Hospital, Goyang, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Hye Young</ForeName><Initials>HY</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Pusan National University Hospital, Busan, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Park</LastName><ForeName>Su Eun</ForeName><Initials>SE</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Joon Kee</ForeName><Initials>JK</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jo</LastName><ForeName>Dae Sun</ForeName><Initials>DS</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Jeonbuk National University Medical School, Jeonju, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cho</LastName><ForeName>Seung-Man</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Dongguk University College of Medicine, Gyeongju, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Choi</LastName><ForeName>Jae Hong</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jo</LastName><ForeName>Kyo Jin</ForeName><Initials>KJ</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Choe</LastName><ForeName>Young June</ForeName><Initials>YJ</Initials><AffiliationInfo><Affiliation>Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Ki Hwan</ForeName><Initials>KH</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Jong-Hyun</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, St Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>JAMA Pediatr</MedlineTA><NlmUniqueID>101589544</NlmUniqueID><ISSNLinking>2168-6203</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D012367">RNA, Viral</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>JAMA Pediatr. 2021 Jan 1;175(1):16-18</RefSource><PMID Version="1">32857158</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000367" MajorTopicYN="N">Age 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