Screening and Severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain

12 Apr, 2020


As the pandemic of coronavirus disease 2019 (COVID-19) spreads, new data emerge and understanding of the disease improves. Reports associated with children are growing but still scarce. The epicenter of the epidemic has displaced to Europe. The first case in Spain was declared on January 31, 2020, and the first case in the Madrid region was declared on February 27, 2020.


With the aim of obtaining an overview of the proportion of confirmed cases among those tested and the severity of the disease in children, a registry of tested cases was performed from March 2, 2020, to March 16, 2020, by pediatricians in 30 secondary and tertiary hospitals in Madrid, Spain, during the first 2 weeks of the epidemic. Children were screened according to Spanish Public Health recommendations, which included those patients with a significant disease who were admitted, or likely to be admitted, at the time of evaluation according to the attending pediatrician or patients with signs or symptoms compatible with COVID-19 and the risk of complications due to baseline disease. This study was approved by the ethics committee of Hospital 12 de Octubre. Data collection was allowed by verbal consent with subsequent written consent provided by patients with positive results. Data were deidentified. The test used for diagnosis was real-time polymerase chain reaction. The reported sensitivities for the E gene and RdRp gene assays are 5.2 and 3.8 copies per reaction at 95% detection probability, respectively. Both genes needed to be amplified to report a positive result.


During the first 2 weeks of the epidemic in Madrid, Spain, 365 children were screened within the 30 hospitals. During the first week, 6 of 103 patients (5.8%) had positive test results. At the end of the second week, 41 of 365 patients (11.2%) had positive test results (Table). By March 16, 2020, 41 of the 4695 confirmed cases (0.8%) in Madrid region were children younger than 18 years.

Table). Of these, 1 of 4 (25%) had only 1 previous condition (recurrent wheezing). No patients died. Initial syndromic diagnoses were upper respiratory tract infection (14 [34%]), fever without a source (11 [27%]), viral-like pneumonia (6 [15%]), bronchiolitis (5 [12%]), gastroenteritis or vomiting (2 [5%]), bacterial-like pneumonia (2 [5%]), and asthma flare (1 [2%]). Two patients (5%) had a coinfection with influenza B.