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Children and COVID-19 Research Library

UNDER DEVELOPMENT UNICEF Innocenti's curated library of COVID-19 + Children research

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Age-dependent effects in the transmission and control of COVID-19 epidemics

Nicholas Davies; Petra Klepac; Yang Liu

Published: July 2020   Nature Medicine
The COVID-19 pandemic has shown a markedly low proportion of cases among children1,2,3,4. Age disparities in observed cases could be explained by children having lower susceptibility to infection, lower propensity to show clinical symptoms or both. We evaluate these possibilities by fitting an age-structured mathematical model to epidemic data from China, Italy, Japan, Singapore, Canada and South Korea. We estimate that susceptibility to infection in individuals under 20 years of age is approximately half that of adults aged over 20 years, and that clinical symptoms manifest in 21% (95% credible interval: 12–31%) of infections in 10- to 19-year-olds, rising to 69% (57–82%) of infections in people aged over 70 years. Accordingly, we find that interventions aimed at children might have a relatively small impact on reducing SARS-CoV-2 transmission, particularly if the transmissibility of subclinical infections is low. Our age-specific clinical fraction and susceptibility estimates have implications for the expected global burden of COVID-19, as a result of demographic differences across settings. In countries with younger population structures—such as many low-income countries—the expected per capita incidence of clinical cases would be lower than in countries with older population structures, although it is likely that comorbidities in low-income countries will also influence disease severity. Without effective control measures, regions with relatively older populations could see disproportionally more cases of COVID-19, particularly in the later stages of an unmitigated epidemic.
Reflection on lower rates of COVID-19 in children: Does childhood immunizations offer unexpected protection?

Lyu Jinglu; Tianyu Miao; Ranran Cao; et al.

Published: July 2020   Medical Hypotheses
The incidence of COVID-19 in children and teenagers is only about 2% in China. Children had mild symptoms and hardly infected other children or adults. It is worth considering that children are the most vulnerable to respiratory pathogens, but fatal SARS-like virus had not caused severe cases among them. According to the pathological studies of COVID-19 and SARS, a sharp decrease in T lymphocytes leads to the breakdown of the immune system. The cellular immune system of children differs from that of adults may be the keystone of atypical clinical manifestations or even covert infection. The frequent childhood vaccinations and repeated pathogens infections might be resulting in trained immunity of innate immune cells, immune fitness of adaptive immune cells or cross-protection of antibodies in the children. Therefore, due to lack of specific vaccine, some vaccines for tuberculosis, influenza and pneumonia may have certain application potential for the front-line health workers in the prevention and control of COVID-19. However, for high-risk susceptible populations, such as the elderly with basic diseases such as hypertension and diabetes, it is necessary to explore the remedial effect of the planned immune process on their immunity to achieve the trained immunity or immune fitness, so as to improve their own antiviral ability.
Cite this research | Open access | Vol.: 143 | No. of pages: 6 | Tags: adolescents, children, immunization, COVID-19 response, COVID-19 | Topics: Health, Child Protection | Countries: China
An investigation of mental health status of children and adolescents in China during the outbreak of COVID-19

Li Duan; Xiaojun Shao; Yuan Wang; et al.

Published: July 2020   Journal of Affective Disorders
This study investigates the psychological effects on children and adolescents associated with the epidemic in China. Findings indicate that the COVID-19 outbreak has had a significant psychosocial impact on children and adolescents. The presence of clinical depressive symptoms, resident in urban regions, implementation of the precaution and control measures, being female, having a family member or friend infected with coronavirus were associated with increased levels of anxiety.
Smartphone addiction, Internet addiction, family members or friends infected with coronavirus, graduation affected by the epidemic, levels of separation anxiety, physical injury fear, and tendency to adopt an emotion-focused coping style were associated with increased levels of respondents’ depressive symptoms.
Targeted intervention measures could be formulated based on the significant influencing factors on anxiety and clinical depressive symptoms.

Behavioural and Emotional Disorders in Children During the COVID-19 Epidemic

Wen YanJiao; Lin Na Wang; Juan Liu; et al.

Published: June 2020   The Journal of Pediatrics

Since December 2019, health systems around the globe have struggled with an increasing number of cases of a viral respiratory syndrome that emerged in China. The cause is a new strain in the coronavirus family, provisionally named 2019 novel coronavirus (2019-nCoV)1, SARS-CoV-2 or COVID-19. The European Paediatric Association–Union of National European Paediatric Societies and Associations (EPA-UNEPSA) has established a collaborative working group with key Chinese academic institutions and medical centers with the purpose of facilitating the reciprocal exchange of information and sharing scientific knowledge. The aim of this commentary by the China-EPA-UNEPSA working group is to raise awareness regarding children's psychological needs during epidemics and report early data collected in the COVID-19–affected areas in China during the current outbreak, emphasizing the role of families and caregivers in the timely recognition and management of negative emotions.

Response to children’s physical and mental needs during the COVID-19 outbreak

Xiao-Bo Zhang; Yong-Hao Gui; Xiu Xu; et al.

Published: May 2020   World Journal of Pediatrics
School closure and stay-at-home, as a part of non-pharmaceutical interventions (NPI), have been implemented in China since February as an effective way to mitigate the spread of the virus during the COVID-19 outbreak. As concerns rose over the potential impacts of such NPI measures on children’s health, such as longer exposure to digital screens, irregular sleep pattern, weight gain, and loss of cardiorespiratory fitness [1], the Chinese Government, experts on public health, educators on school health, and teachers have been making joint and massive efforts to provide distance learning with well-organized online courses to help.
Age profile of susceptibility, mixing, and social distancing shape the dynamics of the novel coronavirus disease 2019 outbreak in China

Juanjuan zhang; Maria Litvinova; Yuxia Liang; et al.

Published: March 2020   MedRXiv
Strict interventions were successful to control the novel coronavirus (COVID-19) outbreak in China. As transmission intensifies in other countries, the interplay between age, contact patterns, social distancing, susceptibility to infection and disease, and COVID-19 dynamics remains unclear. To answer these questions, we analyze contact surveys data for Wuhan and Shanghai before and during the outbreak and contact tracing information from Hunan Province. Daily contacts were reduced 7-9 fold during the COVID-19 social distancing period, with most interactions restricted to the household. Children 0-14 years were 59% (95% CI 7-82%) less susceptible than individuals 65 years and over. A transmission model calibrated against these data indicates that social distancing alone, as implemented in China during the outbreak, is sufficient to control COVID-19. While proactive school closures cannot interrupt transmission on their own, they reduce peak incidence by half and delay the epidemic. These findings can help guide global intervention policies.
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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents. Learn more.


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UNICEF Innocenti is mobilizing a rapid research response in line with UNICEF’s global response to the COVID-19 crisis. The initiatives we’ve begun will provide the broad range of evidence needed to inform our work to scale up rapid assessment, develop urgent mitigating strategies in programming and advocacy, and preparation of interventions to respond to the medium and longer-term consequences of the COVID-19 crisis. The research projects cover a rapid review of evidence, education analysis, and social and economic policies.