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    2 Comments for this article
    Age range of study sample
    Eugenie Coakley, MA, MPH, PStat |
    This very good article is on an important and timely topic. I wonder about the definition of children, however. The overall median age was 8.4 years, but the maximum age was 35.6 years (40.4 years for the influenza group). Could some long-term patients of the Children's National Hospital have been included in the sample? Clarification of the inclusion criterion regarding age would be helpful.
    CONFLICT OF INTEREST: None Reported
    Re: age range in study sample
    Xiaoyan Song, PhD, MBBS | Children's National Hospital, Washington, D.C
    As a pediatric hospital, we provide care to patients with congenital issues regardless of age at the time of diagnosis. We also provide care to patients with diseases (e.g. cystic fibrosis) that were used to be associated with a short life span. With advances of modern medicine, these patients now can survive much longer and live in their adult life. Although these patients are often transitioned into adult care, some choose to stay with their pediatric specialist. These patient populations constitute the study patients of older age.
    CONFLICT OF INTEREST: None Reported
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    Original Investigation
    Infectious Diseases
    September 8, 2020

    Comparison of Clinical Features of COVID-19 vs Seasonal Influenza A and B in US Children

    Author Affiliations
    • 1Office of Infection Control and Epidemiology, Children’s National Hospital, Washington, DC
    • 2Department of Pediatrics, George Washington University School of Health Science, Washington, DC
    • 3Department of Laboratory Medicine, Children’s National Hospital, Washington, DC
    • 4Division of Quality and Safety, Children’s National Hospital, Washington, DC
    • 5Chief Medical Office, Children’s National Hospital, Washington, DC
    • 6Division of Infectious Disease, Children’s National Hospital, Washington, DC
    JAMA Netw Open. 2020;3(9):e2020495. doi:10.1001/jamanetworkopen.2020.20495
    Key Points español 中文 (chinese)

    Question  What are the similarities and differences in clinical features between coronavirus disease 2019 (COVID-19) and seasonal influenza in US children?

    Findings  In this cohort study of 315 children with COVID-19 and 1402 children with seasonal influenza, there were no statistically significant differences in the rates of hospitalization, admission to the intensive care unit, and mechanical ventilator use between the 2 groups. More patients with COVID-19 than with seasonal influenza reported fever, diarrhea or vomiting, headache, body ache, or chest pain at the time of diagnosis.

    Meaning  The findings suggest that prevention of both COVID-19 and seasonal influenza in US children is prudent and urgent for the well-being of this population.

    Abstract

    Importance  Compared with seasonal influenza, the clinical features and epidemiologic characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus 2019 (COVID-19) in US children remain largely unknown.

    Objective  To describe the similarities and differences in clinical features between COVID-19 and seasonal influenza in US children.

    Design, Setting, and Participants  This retrospective cohort study included children who were diagnosed with laboratory-confirmed COVID-19 between March 25 and May 15, 2020, and children diagnosed with seasonal influenza between October 1, 2019, and June 6, 2020, at Children’s National Hospital in the District of Columbia.

    Exposures  COVID-19 or influenza A or B.

    Main Outcomes and Measures  Rates of hospitalization, admission to the intensive care unit, and mechanical ventilator use and the association between underlying medical conditions, clinical symptoms, and COVID-19 vs seasonal influenza.

    Results  The study included 315 patients diagnosed with COVID-19 (164 [52%] male; median age, 8.3 years [range, 0.03-35.6 years]) and 1402 patients diagnosed with seasonal influenza (743 [53%] male; median age, 3.9 years [range, 0.04-40.4 years]). Patients with COVID-19 and those with seasonal influenza had a similar hospitalization rate (54 [17%] vs 291 [21%], P = .15), intensive care unit admission rate (18 [6%] vs 98 [7%], P = .42), and use of mechanical ventilators (10 [3%] vs 27 [2%], P = .17). More patients hospitalized with COVID-19 than with seasonal influenza reported fever (41 [76%] vs 159 [55%], P = .005), diarrhea or vomiting (14 [26%] vs 36 [12%], P = .01), headache (6 [11%] vs 9 [3%], P = .01), body ache or myalgia (12 [22%] vs 20 [7%], P = .001), and chest pain (6 [11%] vs 9 [3%], P = .01). Differences between patients hospitalized with COVID-19 vs influenza who reported cough (24 [48%] vs 90 [31%], P = .05) and shortness of breath (16 [30%] vs 59 [20%], P = .13) were not statistically significant.

    Conclusions and Relevance  In this cohort study of US children with COVID-19 or seasonal influenza, there was no difference in hospitalization rates, intensive care unit admission rates, and mechanical ventilator use between the 2 groups. More patients hospitalized with COVID-19 than with seasonal influenza reported clinical symptoms at the time of diagnosis.

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