Middle East respiratory syndrome coronavirus disease is rare in children: An update from Saudi Arabia

Table 1 Summary of reported pediatric Middle East respiratory syndrome cases

Age	Gender	Country	Sample source	Year of reporting	Symptoms	Co-morbidity	Signs	Sample type	Viral load ct value	Imaging	Intensive care	Death	Ref.
2	Male	KSA	Hospital inpatient	2013	Fever, respiratory distress	Cystic fibrosis	Chest: Bilateral fine crepitation	NPS	36	Bilateral diffused infiltrate	+	Yes	[18]
14	Female	KSA	Hospital inpatient	2013	Fever	Down’s syndrome		NPS	37	Bilateral diffused infiltrate	No	No	[18]
7	Female	KSA	Family contact	2013	Asymptomatic	None	None	N + T	37	ND	No	No	[18]
15	Female	KSA	Family contact	2014	Asymptomatic	None	None	NPS	35	ND	No	No	[18]
14	Male	KSA	Family contact	2014	Asymptomatic	None	None	NPS	34	ND	No	No	[18]
12	Female	KSA	Family contact	2014	Asymptomatic	None	None	NPS	35	ND	No	No	[18]
16	male	KSA	Family contact	2013	Asymptomatic	None	none	NPS	36	ND	No	No	[18]
7	Female	KSA	Family contact	2014	Asymptomatic	None	none	NPS	37	ND	No	No	[18]
3	Female	KSA	Family contact	2013	Asymptomatic	None	none	NPS	38	ND	No	No	[18]
13	Female	KSA	Contact	2014	Asymptomatic	None	none	NPS	34	ND	No	No	[18]
14	Female	KSA	Family contact	2013	Asymptomatic	None	none	NPS	36	ND	No	No	[18]
0.75	Male	KSA	Not known	2014	ICU	Nephrotic syndrome	Respiratory distress	Tracheal aspirate	NA	Diffuse bilateral haziness	Yes	Yes	[35]
4	Male	KSA	NA	2013	Mild respiratory symptoms	None	NA		NA	ND	No	No	[36]
8	Male	KSA	NA	2013	Mild respiratory symptoms	None	NA		NA	ND	NA	No	[37]
17	NA	KSA	Contact	2014	Asymptomatic	NA	NA	NA	NA	NA	NA	NA	[22]
11	NA	KSA	Contact	2014	Asymptomatic	NA	NA	NA	NA	NA	NA	NA	[22]
16	NA	KSA	NA	2014	Symptomatic	NA	NA	NA	NA	NA	NA	NA	[22]
13	M	KSA	NA	2014	Symptomatic	NA	NA	NA	NA	NA	NA	NA	[22]
10	M	KSA	Hospital contact	2014	Symptomatic	NA	NA	NA	NA	NA	NA	NA	[20,22]
2	NA	KSA	NA	2014	Symptomatic	Congenital anomalies	NA	NA	NA	NA	NA	NA	[20,22]
11	M	KSA	Hospital contact	2014	Symptomatic	Brain tumor	NA	NA	NA	NA	NA	NA	[20,22]
17	M	KSA	NA	2014	Symptomatic	NA	NA	NA	NA	NA	NA	NA	[20,22]
16	M	South Korea	Hospital contact	2015	Symptomatic	NA	NA	NA	NA	NA	NA	NA	[22]
2	M	KSA	Hospital contact	2015	Symptomatic	NA	NA	NA	NA	NA	NA	NA	[20,22]
16	M	KSA	contact	2015	Symptomatic	NA	NA	NA	NA	NA	NA	NA	[20,22]
7	F	Jordan	Contact	2015	Asymptomatic	None	NA	NA	NA	NA	NA	NA	[22]
0.8	F	Jordan	Contact	2015	Symptomatic	None	NA	NA	NA	NA	NA	NA	[22]
14	M	KSA	Contact	2015	Symptomatic	None	NA	NA	NA	NA	NA	NA	[20,22]
4	M	UAE	NA	2014	NA	NA	NA	NA	NA	NA	NA	NA	[22]
8	M	UAE	Family contact	2013	NA	NA	NA	NA	NA	NA	NA	NA	[22]
11	M	UAE	Family contact	2015	Asymptomatic	None	NA	NA	NA	NA	NA	NA	[22]

NPS: Nasopharyngeal swab; N + T: Nasal and tracheal aspirate; ND: Not done; KSA: Kingdom of Saudi Arabia; UAE: United Arab Emirates; ICU: Intensive care unit; NA: Not available.

Table 2 Summary of the demographic characteristics of pediatric Middle East respiratory syndrome-coronavirus

	No.	%
Male:female	17:10 (1.7:1)	63 vs 37
Saudi	20	83.3
City
Jeddah	7	29.2
Riyadh	7	29.2
Hafr al-Batin	3	12.5
Symptomatic	12	50.0
Death	8	33.3
Year of report
2013	9	29
2014	15	48.4
2015	7	22.6

Table 3 Summary of different studies examining Middle East respiratory syndrome-coronavirus infection in children

Country	Testing method	Population	Positive n (%)	Yr	Ref.
KSA	rRT-PCR	Screening of children	9/552 (1.6)		[23]
KSA	Neutralizing antibodies testing	Serum samples from children hospitalized for lower respiratory tract infections	0/158 (0)	May 2010-May 2011	[25]
Jordan	rRT-PCR	Hospitalized children < 2 yr of age	0/2427 (0)		[24]

rRT-PCR: Real time reverse transcriptase polymerase chain reaction; KSA: Kingdom of Saudi Arabia.

Table 4 Summary of pregnancy associated Middle East respiratory syndrome-coronavirus infection

Age of the patient (yr)	Gestational age	Fetal outcome	Diagnostic test	Country	Ref.
39	5 mo	Still birth	Antibody by EIA	Jordan	[26]
33	32 wk	Healthy infant	PCR	Saudi Arabia	[27]
32	32 wk	Healthy	PCR	United Arab Emirates	[28]
34	34 wk	Died	PCR	Saudi Arabia	[29]
32	38 wk	Survived	PCR	Saudi Arabia	[29]
31	24 wk	Died	PCR	Saudi Arabia	[29]
27	22 wk	Survived	PCR	Saudi Arabia	[29]
30	23 wk	Survived	PCR	Saudi Arabia	[29]

PCR: Polymerase chain reaction; EIA: Enzyme immunoassay.