Clinical presentations and outcome of severe acute respiratory syndrome in children

TLDR

Hong Kong was heavily impacted by SARS, with household and healthcare transmission posing a particular risk to children, yet most existing data focus on adults. The study prospectively followed the first ten children with SARS, all of whom had close contact with infected adults, during the epidemic’s early phase. All ten children exhibited persistent fever, cough, progressive chest radiographic changes, and lymphopenia; they were treated with high‑dose ribavirin and steroids without short‑term adverse effects, with four teenagers requiring oxygen and two needing ventilation, while younger children did not need oxygen, indicating a less aggressive course in younger children compared to adults and teenagers.

Abstract

Hong Kong has been severely affected by severe acute respiratory syndrome (SARS). Contact in households and healthcare settings is thought to be important for transmission, putting children at particular risk. Most data so far, however, have been for adults. We prospectively followed up the first ten children with SARS managed during the early phase of the epidemic in Hong Kong. All the children had been in close contact with infected adults. Persistent fever, cough, progressive radiographic changes of chest and lymphopenia were noted in all patients. The children were treated with high-dose ribavirin, oral prednisolone, or intravenous methylprednisolone, with no short-term adverse effects. Four teenagers required oxygen therapy and two needed assisted ventilation. None of the younger children required oxygen supplementation. Compared with adults and teenagers, SARS seems to have a less aggressive clinical course in younger children.