The First Six Registered Pediatric Cases with COIVID-19 in Libya: A Case Study

Globally, fewer cases of COVID-19 have been reported in children (age 0-17 years) compared with adults [1,2], The number and rate of cases in children have been steadily increasing since March 2020. The true incidence of SARS-CoV-2 infection in children is not known due to lack of widespread testing and the prioritization of testing for adults and those with severe illness. Hospitalization rates in children are significantly lower than hospitalization rates in adults with COVID-19, suggesting that children may have less severe illness from COVID-19 compared to adults [5,6].

Evidence suggests that compared to adults, children likely have similar viral loads in their nasopharynx, [7] similar secondary infections rates, and can spread the virus to others [8,9].

Due to community mitigation measures and school closures, transmission of SARS-CoV-2 to and among children may have been reduced during the pandemic in the spring and early summer of 2020. This may explain the low incidence in children compared with adults.

Comparing trends in pediatric infections before and after the return to child care, in-person school, youth sports and other activities may enhance our understanding about infections in children.

Children infected with SARS-CoV-2 may have many of these non-specific symptoms, only have a few (such as only upper respiratory symptoms or only gastrointestinal symptoms), or may be asymptomatic. The most common symptoms in children are cough and/or fever [11-15]. A recent systematic review estimated that 16% of children with SARS-CoV-2 infection are asymptomatic, [16] but evidence suggests that as many as half of pediatric infections may be asymptomatic [17] The signs and symptoms of COVID-19 in children are similar to those of other infections and noninfectious processes, including influenza, streptococcal pharyngitis, and allergic rhinitis. The lack of specificity of signs or symptoms and the significant proportion of asymptomatic infections make symptom-based screening for identification of SARS-CoV-2 in children particularly challenging [17].