Comparison of clinical features of COVID-19 and seasonal flu in children

Editor's Note

This cohort study of US children with COVID-19 or seasonal flu found no difference in hospitalization rates, ICU admission rates, or mechanical ventilator use between the two groups. More COVID-19 patients reported clinical symptoms at the time of diagnosis.

The study included 315 children with COVID-19 (median age 8.3 years) and 1,402 with seasonal flu (median age 3.9 years) diagnosed between October 1, 2019, and June 6, 2020, at Children’s National Hospital, Washington, DC.

Both groups had similar:

• hospitalization rates (17% vs 21%)
• ICU admission rates (6% vs 7%)
• use of mechanical ventilators (3% vs 2%).

More children hospitalized with COVID-19 than seasonal flu reported:

• fever (76% vs 55%)
• diarrhea or vomiting (26% vs 12%)
• headache (11% vs 3%)
• body ache or myalgia (22% vs 7%)
• chest pain (11% vs 3%).

Differences between children with COVID-19 and seasonal flu who reported cough (48% vs 31%) and shortness of breath (30% vs 20%) were not statistically significant.

Findings from the study may inform the prompt identification and treatment of children with a respiratory viral infection, the authors say.