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Medwave 2020;20(8):e8025 doi: 10.5867/medwave.2020.08.8025
Characterization of coronavirus disease 2019 (COVID-19) in children and adolescents in Latin American and the Caribbean countries: A descriptive study
Noé Atamari-Anahui, Nelson Deyvis Cruz-Nina, Mirian Condori-Huaraka, Héctor Nuñez-Paucar, Evelina Andrea Rondón-Abuhadba, Marco Edmundo Ordoñez-Linares, César Johan Pereira-Victoriod
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Key Words: coronavirus, coronavirus infections, COVID-19, child, pediatrics, latin america

Abstract

Introduction
Coronavirus disease 2019 has been reported in the pediatric population; however, there is limited information in Latin American and the Caribbean countries.

Objectives
To describe the frequency of cases, deaths, incidence, and case fatality rate attributed to COVID-19 in children and adolescents from Latin American and the Caribbean countries.

Methods
An observational study was carried-out using COVID-19 case registries in children and adolescents published by the Ministries of Health of 19 countries in Latin American and the Caribbean countries until May 20, 2020. Cases and deaths were classified by sex and age group. Also, incidence and case fatality rates were calculated for each country.

Results
A total of 20,757 (4.2% of all patients) cases of COVID-19 were reported in children from 0 to 19 years of age. 52.4% was in the group aged 10 to 19 years. 50.6% were male. 139 (0.26%) deaths were reported in children from 0 to 19 years. The accumulated incidence was higher in Chile, Panama, and Peru. The cumulative incidence per 100,000 inhabitants ranged from 1.26 to 77.55 in the population from 0 to 9 years old, 1.57 to 98.84 from 10 to 19 years old, and 0.91 to 88.34 from 0 to 19 years old. The case fatality rate in children from 0 to 19 years old ranged from 0 to 9.09%.

Conclusion
In 19 Latin American and the Caribbean countries, the frequency of cases, cumulative incidence, case fatality rate in children and adolescents was heterogeneous. These results contribute to understanding the epidemiological behavior of this disease in children and adolescents of the countries included in the study.


 

No English version is available for this article.

Licencia Creative Commons Esta obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.

 

Introducción
La enfermedad por coronavirus 2019 ha sido reportada en la población pediátrica; sin embargo, existe limitada información en países de América Latina y El Caribe.

Objetivos
Describir la frecuencia de casos, defunciones, incidencia acumulada y letalidad atribuida a COVID-19 en niños y adolescentes de países de América Latina y El Caribe.

Métodos
Se realizó un estudio observacional utilizando los registros de casos atribuidos a COVID-19 en niños y adolescentes publicados por los Ministerios de Salud de 16 países de América Latina y tres países de El Caribe hasta el 20 de mayo de 2020. Se clasificaron los casos y las defunciones por sexo y grupo de edad. Además, se calcularon la incidencia acumulada y letalidad por cada país.

Resultados
Se reportaron 20 757 casos de COVID-19 de 0 a 19 años (4,2% del total de enfermos). El 52,4% fue en el grupo de 10 a 19 años. El 50,6% fueron del sexo masculino. Se registraron 139 (0,26% del total) defunciones de 0 a 19 años. La incidencia acumulada fue mayor en Chile, Panamá y Perú. La incidencia acumulada por 100 000 habitantes varió de 1,26 a 77,55 en la población de 0 a 9 años, de 1,57 a 98,84 entre 10 a 19 años y de 0,91 a 88,34 entre 0 a 19 años. La letalidad de 0 a 19 años tuvo un rango de 0 a 9,09%.

Conclusiones
En 19 países de Latinoamérica y El Caribe, la frecuencia de casos, incidencia acumulada, letalidad en niños y adolescentes fue heterogénea. Estos resultados contribuyen a comprender el comportamiento epidemiológico de esta enfermedad en niños y adolescentes en los países incluidos en el estudio.

Authors: Noé Atamari-Anahui[1,2], Nelson Deyvis Cruz-Nina[3], Mirian Condori-Huaraka[3], Héctor Nuñez-Paucar[2], Evelina Andrea Rondón-Abuhadba[3], Marco Edmundo Ordoñez-Linares[3], César Johan Pereira-Victoriod[4]

Affiliation:
[1] Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Perú
[2] Instituto Nacional de Salud del Niño-Breña, Lima, Perú
[3] Asociación Científica de Estudiantes de Medicina Humana (ASOCIEMH CUSCO), Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Perú
[4] Universidad Continental, Lima, Perú

E-mail: noe.atamari@gmail.com

Author address:
[1] Avenida La Fontana 550, La Molina
Lima, Perú

Citation: Atamari-Anahui N, Cruz-Nina ND, Condori-Huaraka M, Nuñez-Paucar H, Rondón-Abuhadba EA, Ordoñez-Linares ME, et al. Characterization of coronavirus disease 2019 (COVID-19) in children and adolescents in Latin American and the Caribbean countries: A descriptive study. Medwave 2020;20(8):e8025 doi: 10.5867/medwave.2020.08.8025

Submission date: 1/6/2020

Acceptance date: 31/8/2020

Publication date: 16/9/2020

Origin: Not commissioned

Type of review: Externally peer-reviewed by three reviewers, double-blind

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  1. Cavallo F, Rossi N, Chiarelli F. Novel coronavirus infection and children. Acta Biomed. 2020 May 11;91(2):172-176. | CrossRef | PubMed |
  2. World Health Organization (WHO). WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. 2020. [On line]. | Link |
  3. Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020 Jun;109(6):1088-1095. | CrossRef | PubMed |
  4. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24. | CrossRef | PubMed |
  5. Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020 Mar 17. | CrossRef | PubMed |
  6. CDC COVID-19 Response Team. Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020 Apr 10;69(14):422-426. | CrossRef | PubMed |
  7. Brodin P. Why is COVID-19 so mild in children? Acta Paediatr. 2020 Jun;109(6):1082-1083. | CrossRef | PubMed |
  8. Liguoro I, Pilotto C, Bonanni M, Ferrari ME, Pusiol A, Nocerino A, et al. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr. 2020 Jul;179(7):1029-1046. | CrossRef | PubMed |
  9. Song R, Han B, Song M, Wang L, Conlon CP, Dong T, et al. Clinical and epidemiological features of COVID-19 family clusters in Beijing, China. J Infect. 2020 Aug;81(2):e26-e30. | CrossRef | PubMed |
  10. Burki T. COVID-19 in Latin America. Lancet Infect Dis. 2020 May;20(5):547-548. | CrossRef | PubMed |
  11. Olmos C, Cepeda J, Zenteno D. Nuevo coronavirus (covid-19) en población general y pediátrica: Una revisión epidemiológica. Chile 2020. Neumol Pediatr. 2020;15(2):293-300. [On line] | Link |
  12. Carrillo-Larco RM. COVID-19 data sources in Latin America and the Caribbean. Travel Med Infect Dis. 2020 May 29:101750. | CrossRef | PubMed |
  13. Ccorahua-Ríos MS, Atamari-Anahui N, Miranda-Abarca I, Campero-Espinoza AB, Rondón-Abuhadba EA, Pereira-Victorio CJ. Type 2 diabetes mellitus prevalence between 2005 and 2018 in population under 30 using data from the Ministry of Health of Peru. Medwave. 2019 Nov 13;19(10):e7723. Spanish, English. | CrossRef | PubMed |
  14. Herrera-Añazco P, Ccorahua-Ríos MS, Condori-Huaraka M, Huamanvilca-Yepez Y, Amaya E, Atamari-Anahui N. National trends in age-standardized incidence and mortality rates of acute kidney injury in Peru. J Bras Nefrol. 2020 Mar 23:S0101-28002020005007201. Portuguese, English. | CrossRef | PubMed |
  15. Pollán M, Pérez-Gómez B, Pastor-Barriuso R, Oteo J, Hernán MA, Pérez-Olmeda M, et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet. 2020 Aug 22;396(10250):535-544. | CrossRef | PubMed |
  16. Gutiérrez-Aguilar R, Córdova-Lepe F, Muñoz-Quezada MT, Gutiérrez-Jara JP. Modelo de umbral de reducción de tasa diaria de casos COVID-19 para evitar el colapso hospitalario en Chile [Model for a threshold of daily rate reduction of COVID-19 cases to avoid hospital collapse in Chile]. Medwave. 2020 Apr 8;20(3):e7871. Spanish. | CrossRef | PubMed |
  17. Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. 2020 May;4(5):397-404. | CrossRef | PubMed |
  18. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020 Mar 21;395(10228):931-934. | CrossRef | PubMed |
  19. Kirby T. South America prepares for the impact of COVID-19. Lancet Respir Med. 2020 Jun;8(6):551-552. | CrossRef | PubMed |
  20. Rizo-Patron E, Padilla J, Tantalean JA. Demanda hospitalaria pediátrica en tiempos de COVID-19 en Perú. 2020. [On line] | Link |
  21. Denova-Gutiérrez E, Lopez-Gatell H, Alomia-Zegarra JL, López-Ridaura R, Zaragoza-Jimenez CA, Dyer-Leal DD, et al. The Association of Obesity, Type 2 Diabetes, and Hypertension with Severe Coronavirus Disease 2019 on Admission Among Mexican Patients. Obesity (Silver Spring). 2020 Jul 1:10.1002/oby.22946. | CrossRef | PubMed |
  22. Munayco CV, Tariq A, Rothenberg R, Soto-Cabezas GG, Reyes MF, Valle A, et al. Early transmission dynamics of COVID-19 in a southern hemisphere setting: Lima- Peru: February 29th-March 30th, 2020. Infect Dis Model. 2020 May 12;5:338-345. | CrossRef | PubMed |
  23. Paniz-Mondolfi AE, Sordillo EM, Márquez-Colmenarez MC, Delgado-Noguera LA, Rodriguez-Morales AJ. The arrival of SARS-CoV-2 in Venezuela. Lancet. 2020 May 16;395(10236):e85-e86. | CrossRef | PubMed |
  24. Caballero RL. Voluntad política e intersectorialidad para el enfrentamiento a la COVID-19 en Cuba. Rev Habanera Cienc Médicas. 2020;19(2):3241. [On line] | Link |
  25. Cimerman S, Chebabo A, Cunha CAD, Rodríguez-Morales AJ. Deep impact of COVID-19 in the healthcare of Latin America: the case of Brazil. Braz J Infect Dis. 2020 Mar-Apr;24(2):93-95. | CrossRef | PubMed |
  26. Navarro JC, Arrivillaga-Henríquez J, Salazar-Loor J, Rodriguez-Morales AJ. COVID-19 and dengue, co-epidemics in Ecuador and other countries in Latin America: Pushing strained health care systems over the edge. Travel Med Infect Dis. 2020 Apr 5:101656. | CrossRef | PubMed |
  27. Atamari-Anahui N, Ccorahua-Ríos MS, Cabrera-Enríquez JA, Vilcarromero S. La implicancia del reordenamiento genético en el diagnóstico y la epidemiología del virus Oropuche en el Perú [The implication of genetic rearrangement in the diagnosis and epidemiology of Oropuche virus in Peru]. Salud Publica Mex. 2018 Sep-Oct;60(5):487-488. Spanish. | CrossRef | PubMed |
  28. Vilar-Compte M, Pérez V, Teruel G, Alonso A, Pérez-Escamilla R. Costing of actions to safeguard vulnerable Mexican households with young children from the consequences of COVID-19 social distancing measures. Int J Equity Health. 2020 May 19;19(1):70. | CrossRef | PubMed |
  29. Sánchez-Tauma PJ, Atamari-Anahui N, Valera-Moreno C. Enfermedad por Coronavirus 2019, COVID-19: Aspectos a considerar en niños. Rev Cuerpo Méd HNAAA. 2020;13(1):88-94. | CrossRef |
  30. Lanari M, Chiereghin A, Biserni GB, Rocca A, Re MC, Lazzarotto T. Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise. Clin Microbiol Infect. 2020 Jun 25;26(9):1130–2. | CrossRef | PubMed |
  31. Li X, Xu W, Dozier M, He Y, Kirolos A, Theodoratou E. The role of children in transmission of SARS-CoV-2: A rapid review. J Glob Health. 2020 Jun;10(1):011101. | CrossRef | PubMed |
  32. Sun D, Li H, Lu XX, Xiao H, Ren J, Zhang FR, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center's observational study. World J Pediatr. 2020 Jun;16(3):251-259. | CrossRef | PubMed |
  33. de Ceano-Vivas M, Martín-Espín I, Del Rosal T, Bueno-Barriocanal M, Plata-Gallardo M, Ruiz-Domínguez JA, et al. SARS-CoV-2 infection in ambulatory and hospitalised Spanish children. Arch Dis Child. 2020 Aug;105(8):808-809. | CrossRef | PubMed |
  34. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020 Apr 23;382(17):1663-1665. | CrossRef | PubMed |
  35. NYC Health. Italy: coronavirus death rate by age. Statista. 2020. [On line] | Link |
  36. Conto-Palomino NM, Cabrera-Bueno ML, Vargas-Ponce KG, Rondón-Abuhadba EA, Atamari-Anahui N. Encefalitis asociada a COVID-19 en una niña de 13 años: reporte de caso [Encephalitis associated with COVID-19 in a 13-year-old girl: A case report]. Medwave. 2020 Aug 3;20(7):e7984. | CrossRef | PubMed |
  37. Munayco C, Chowell G, Tariq A, Undurraga EA, Mizumoto K. Risk of death by age and gender from CoVID-19 in Peru, March-May, 2020. Aging (Albany NY). 2020 Jul 21;12(14):13869-13881. | CrossRef | PubMed |
  38. Rodriguez-Morales AJ, Sánchez-Duque JA, Botero SH, Pérez-Díaz CE, Villamil-Gómez WE, Méndez CA, et al. Preparación y control de la enfermedad por coronavirus 2019 (COVID-19) en América Latina. Acta Med Peru. 2020;37(1):3-7. [On line] | Link |
Cavallo F, Rossi N, Chiarelli F. Novel coronavirus infection and children. Acta Biomed. 2020 May 11;91(2):172-176. | CrossRef | PubMed |

World Health Organization (WHO). WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. 2020. [On line]. | Link |

Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020 Jun;109(6):1088-1095. | CrossRef | PubMed |

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24. | CrossRef | PubMed |

Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020 Mar 17. | CrossRef | PubMed |

CDC COVID-19 Response Team. Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020 Apr 10;69(14):422-426. | CrossRef | PubMed |

Brodin P. Why is COVID-19 so mild in children? Acta Paediatr. 2020 Jun;109(6):1082-1083. | CrossRef | PubMed |

Liguoro I, Pilotto C, Bonanni M, Ferrari ME, Pusiol A, Nocerino A, et al. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr. 2020 Jul;179(7):1029-1046. | CrossRef | PubMed |

Song R, Han B, Song M, Wang L, Conlon CP, Dong T, et al. Clinical and epidemiological features of COVID-19 family clusters in Beijing, China. J Infect. 2020 Aug;81(2):e26-e30. | CrossRef | PubMed |

Burki T. COVID-19 in Latin America. Lancet Infect Dis. 2020 May;20(5):547-548. | CrossRef | PubMed |

Olmos C, Cepeda J, Zenteno D. Nuevo coronavirus (covid-19) en población general y pediátrica: Una revisión epidemiológica. Chile 2020. Neumol Pediatr. 2020;15(2):293-300. [On line] | Link |

Carrillo-Larco RM. COVID-19 data sources in Latin America and the Caribbean. Travel Med Infect Dis. 2020 May 29:101750. | CrossRef | PubMed |

Ccorahua-Ríos MS, Atamari-Anahui N, Miranda-Abarca I, Campero-Espinoza AB, Rondón-Abuhadba EA, Pereira-Victorio CJ. Type 2 diabetes mellitus prevalence between 2005 and 2018 in population under 30 using data from the Ministry of Health of Peru. Medwave. 2019 Nov 13;19(10):e7723. Spanish, English. | CrossRef | PubMed |

Herrera-Añazco P, Ccorahua-Ríos MS, Condori-Huaraka M, Huamanvilca-Yepez Y, Amaya E, Atamari-Anahui N. National trends in age-standardized incidence and mortality rates of acute kidney injury in Peru. J Bras Nefrol. 2020 Mar 23:S0101-28002020005007201. Portuguese, English. | CrossRef | PubMed |

Pollán M, Pérez-Gómez B, Pastor-Barriuso R, Oteo J, Hernán MA, Pérez-Olmeda M, et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet. 2020 Aug 22;396(10250):535-544. | CrossRef | PubMed |

Gutiérrez-Aguilar R, Córdova-Lepe F, Muñoz-Quezada MT, Gutiérrez-Jara JP. Modelo de umbral de reducción de tasa diaria de casos COVID-19 para evitar el colapso hospitalario en Chile [Model for a threshold of daily rate reduction of COVID-19 cases to avoid hospital collapse in Chile]. Medwave. 2020 Apr 8;20(3):e7871. Spanish. | CrossRef | PubMed |

Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. 2020 May;4(5):397-404. | CrossRef | PubMed |

Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020 Mar 21;395(10228):931-934. | CrossRef | PubMed |

Kirby T. South America prepares for the impact of COVID-19. Lancet Respir Med. 2020 Jun;8(6):551-552. | CrossRef | PubMed |

Rizo-Patron E, Padilla J, Tantalean JA. Demanda hospitalaria pediátrica en tiempos de COVID-19 en Perú. 2020. [On line] | Link |

Denova-Gutiérrez E, Lopez-Gatell H, Alomia-Zegarra JL, López-Ridaura R, Zaragoza-Jimenez CA, Dyer-Leal DD, et al. The Association of Obesity, Type 2 Diabetes, and Hypertension with Severe Coronavirus Disease 2019 on Admission Among Mexican Patients. Obesity (Silver Spring). 2020 Jul 1:10.1002/oby.22946. | CrossRef | PubMed |

Munayco CV, Tariq A, Rothenberg R, Soto-Cabezas GG, Reyes MF, Valle A, et al. Early transmission dynamics of COVID-19 in a southern hemisphere setting: Lima- Peru: February 29th-March 30th, 2020. Infect Dis Model. 2020 May 12;5:338-345. | CrossRef | PubMed |

Paniz-Mondolfi AE, Sordillo EM, Márquez-Colmenarez MC, Delgado-Noguera LA, Rodriguez-Morales AJ. The arrival of SARS-CoV-2 in Venezuela. Lancet. 2020 May 16;395(10236):e85-e86. | CrossRef | PubMed |

Caballero RL. Voluntad política e intersectorialidad para el enfrentamiento a la COVID-19 en Cuba. Rev Habanera Cienc Médicas. 2020;19(2):3241. [On line] | Link |

Cimerman S, Chebabo A, Cunha CAD, Rodríguez-Morales AJ. Deep impact of COVID-19 in the healthcare of Latin America: the case of Brazil. Braz J Infect Dis. 2020 Mar-Apr;24(2):93-95. | CrossRef | PubMed |

Navarro JC, Arrivillaga-Henríquez J, Salazar-Loor J, Rodriguez-Morales AJ. COVID-19 and dengue, co-epidemics in Ecuador and other countries in Latin America: Pushing strained health care systems over the edge. Travel Med Infect Dis. 2020 Apr 5:101656. | CrossRef | PubMed |

Atamari-Anahui N, Ccorahua-Ríos MS, Cabrera-Enríquez JA, Vilcarromero S. La implicancia del reordenamiento genético en el diagnóstico y la epidemiología del virus Oropuche en el Perú [The implication of genetic rearrangement in the diagnosis and epidemiology of Oropuche virus in Peru]. Salud Publica Mex. 2018 Sep-Oct;60(5):487-488. Spanish. | CrossRef | PubMed |

Vilar-Compte M, Pérez V, Teruel G, Alonso A, Pérez-Escamilla R. Costing of actions to safeguard vulnerable Mexican households with young children from the consequences of COVID-19 social distancing measures. Int J Equity Health. 2020 May 19;19(1):70. | CrossRef | PubMed |

Sánchez-Tauma PJ, Atamari-Anahui N, Valera-Moreno C. Enfermedad por Coronavirus 2019, COVID-19: Aspectos a considerar en niños. Rev Cuerpo Méd HNAAA. 2020;13(1):88-94. | CrossRef |

Lanari M, Chiereghin A, Biserni GB, Rocca A, Re MC, Lazzarotto T. Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise. Clin Microbiol Infect. 2020 Jun 25;26(9):1130–2. | CrossRef | PubMed |

Li X, Xu W, Dozier M, He Y, Kirolos A, Theodoratou E. The role of children in transmission of SARS-CoV-2: A rapid review. J Glob Health. 2020 Jun;10(1):011101. | CrossRef | PubMed |

Sun D, Li H, Lu XX, Xiao H, Ren J, Zhang FR, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center's observational study. World J Pediatr. 2020 Jun;16(3):251-259. | CrossRef | PubMed |

de Ceano-Vivas M, Martín-Espín I, Del Rosal T, Bueno-Barriocanal M, Plata-Gallardo M, Ruiz-Domínguez JA, et al. SARS-CoV-2 infection in ambulatory and hospitalised Spanish children. Arch Dis Child. 2020 Aug;105(8):808-809. | CrossRef | PubMed |

Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020 Apr 23;382(17):1663-1665. | CrossRef | PubMed |

NYC Health. Italy: coronavirus death rate by age. Statista. 2020. [On line] | Link |

Conto-Palomino NM, Cabrera-Bueno ML, Vargas-Ponce KG, Rondón-Abuhadba EA, Atamari-Anahui N. Encefalitis asociada a COVID-19 en una niña de 13 años: reporte de caso [Encephalitis associated with COVID-19 in a 13-year-old girl: A case report]. Medwave. 2020 Aug 3;20(7):e7984. | CrossRef | PubMed |

Munayco C, Chowell G, Tariq A, Undurraga EA, Mizumoto K. Risk of death by age and gender from CoVID-19 in Peru, March-May, 2020. Aging (Albany NY). 2020 Jul 21;12(14):13869-13881. | CrossRef | PubMed |

Rodriguez-Morales AJ, Sánchez-Duque JA, Botero SH, Pérez-Díaz CE, Villamil-Gómez WE, Méndez CA, et al. Preparación y control de la enfermedad por coronavirus 2019 (COVID-19) en América Latina. Acta Med Peru. 2020;37(1):3-7. [On line] | Link |