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Since late December 2019, when the epidemic caused by the new coronavirus began in China, considerable experience has been gained and corresponding epidemiological observations have been made.

It has been established that the spectrum of clinical manifestations is quite broad, ranging from asymptomatic or mildly symptomatic cases to cases presenting with acute respiratory failure.

At the end of the previous two months, the clinical characteristics of 425 patients from the city of Wuhan in China, where the pandemic we are experiencing began, were described, as well as 72,314 cases reported by the Chinese Center for Disease Control.

In the first study, the average age of those affected was reported to be 59 years, with no children or adolescents under the age of 15 among the patients.

In the second study, fatal cases were reported mainly among people over 70 years of age, while severe cases concerned individuals whose health was already compromised by coexisting conditions. In addition, only 1% of those affected were school-age children, with no deaths recorded.

Based on these data, the view became established that children do not become ill.

Indeed, in studies that followed, various explanations were proposed.

For example, it was suggested that children’s immune systems are immature, that children are less exposed than adults to infected individuals and social contacts, that they frequently suffer from viral illnesses and therefore have high antibody titers, or that the function and maturity of a specific protein (converting enzyme) that may serve as a receptor for the coronavirus is reduced in children.

Unfortunately, this does not appear to be the case, and the initial optimism regarding children being unaffected was excessive.

More recent studies published in the last few days show that children are also vulnerable to infection with the new coronavirus. Specifically, a study from the Children’s Hospital in Wuhan, China, where the current pandemic began, showed that out of 1,391 children who were tested, 171 were positive for the virus, with half of the children presenting with fever and cough.

It should be noted that 20% of the children were under one year of age, 25% were between 1-5 years, 35% between 6-10 years, and 25% between 11-15 years.

It should be particularly emphasized that 15% were asymptomatic.

This finding shows that children also pose a risk for transmission of the disease in the community because, being asymptomatic, they move around freely. It should also be noted that a proportion of the children had pneumonia while remaining asymptomatic. In total, 3 of the 171 children required mechanical ventilation and one died. Gastrointestinal manifestations were observed in 10% of the children.

Another study from the Children’s Hospital of Shanghai, involving 2,143 children and published in the official journal of the American Academy of Pediatrics, also provides interesting data. According to this study, 5% of the children were asymptomatic and 40% presented with a severe clinical picture covering the full clinical spectrum, with infants accounting for 10%.

This study confirmed person-to-person transmission of the disease and a milder clinical course compared with adults.

Given the fact that children, particularly those of younger ages, are less likely to comply with instructions, have poorer personal hygiene, and have difficulty tolerating masks, gloves and antiseptic solutions, it is to be expected that they will contribute significantly to the transmission of the disease.

This makes it necessary to keep them away from the daily care of their grandparents.

If we also consider that, as a recent study from Princeton University suggests, the virus can survive for hours and days (particularly on metal, plastic and copper surfaces), it becomes clear how easily the virus can also be transmitted through toys and objects with which children come into contact.

It is certainly to be expected that immunosuppressed children are particularly vulnerable. However, this also applies, to a lesser extent, to children with chronic diseases such as asthma and diabetes, compared with middle-aged and older adults, because in children these conditions have not yet caused chronic complications such as obstructive lung disease and vascular disease, respectively.

It is generally believed that the coronavirus is here to stay and, according to certain epidemiological scenarios, may return frequently (annually?) in smaller or larger epidemics. For this reason, researchers are working intensively on the development of a vaccine. There have already been announcements that teams from China, Australia and the USA have completed in vitro studies and have progressed to animal studies.

It is a fact that the pace of research has accelerated and that we will soon witness significant scientific advances. This observation highlights the enormous importance of adhering to preventive measures until science provides a definitive solution.