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6ĭata on the pathogenesis and disease severity of SARS-CoV-2 infection in children are increasing but are still limited compared to the adult data. 5 In a report from the CDC, by February 2022, approximately 75% of children and adolescents had serologic evidence of prior SARS-CoV-2 infection. However, among children and adolescents, the estimated number of SARS-CoV-2 infections that occurred through May 2021 was 4.7 to 8.9 times greater than the number of COVID-19 cases. Seroprevalence data have suggested that, as of mid-2021, most children did not have evidence of prior SARS-CoV-2 infection. 1-4 However, the true burden of pediatric SARS-CoV-2 infection remains unclear, as children with mild symptoms are seldom systematically tested, and contact tracing and seroprevalence studies are not generally conducted.

This section also includes information on risk factors for severe COVID-19, vertical transmission, and infants born to a birth parent with SARS-CoV-2 infection. This section provides an overview of the epidemiology and clinical spectrum of disease, including COVID-19, multisystem inflammatory syndrome in children (MIS-C), and post-COVID conditions. See Guidelines Development for more information. Data on the prevalence of post-COVID conditions in children are limited but suggest that younger children may have fewer persistent symptoms than older children and adults.Įach recommendation in the Guidelines receives a rating for the strength of the recommendation (A, B, or C) and a rating for the evidence that supports it (I, IIa, IIb, or III).The majority of children with MIS-C do not have underlying comorbid conditions. Many patients with MIS-C require intensive care management. A small subset of children and young adults with SARS-CoV-2 infection may develop multisystem inflammatory syndrome in children (MIS-C).Vertical transmission of SARS-CoV-2 appears to be rare, but suspected or probable cases of vertical transmission have been described.Data on the pathogenesis and clinical spectrum of SARS-CoV-2 infection are more limited for children than for adults.

Most children hospitalized for severe COVID-19 have not been fully vaccinated or are not eligible for COVID-19 vaccination.Age (<1 year and 10–14 years) and non-White race/ethnicity are also associated with severe disease. Observational studies describe associations between severe COVID-19 and the presence of ≥1 comorbid conditions, including cardiac disease, neurologic disorders, prematurity (in young infants), diabetes, obesity (particularly severe obesity), chronic lung disease, feeding tube dependence, and immunocompromised status.Most nonhospitalized children with COVID-19 will not require any specific therapy.SARS-CoV-2 infection is generally milder in children than in adults, and a substantial proportion of children with the infection are asymptomatic.