A study of 39 children with laboratory confirmed SARS-CoV-2 infection admitted to KK Women’s and Children’s Hospital (KKH) between January and May 2020 found that 38.5 per cent of children remain asymptomatic. Symptomatic children were more likely to have abnormal laboratory parameters but they did not have a poorer outcome compared to asymptomatic cases.


​Key findings:

  • Main symptoms in symptomatic children were low-grade fever (54.2%), rhinorrhoea (45.8%), sore throat (25%), diarrhoea (12.5%) and loss of smell or taste (5.4%).
  • There was a larger proportion of symptomatic children from 0-4 years of age (75%) compared to older children (53% in children 5-9 years and 64% in children 10-16 years).
  • All children had a mild disease course and were discharged well, with a mean length of hospital stay of 15 days.

COVID-19 Smptoms in Children

Fever, runny nose and sore throat were the most common symptoms reported by children with COVID-19. In addition about 12 per cent and 5.4 per cent of children reported diarrhea and loss of smell or taste respectively.

“Loss of small or taste was also documented in some children which have been shown to be an important diagnostic marker for COVID-19 in adults,” shares corresponding author, Dr Li Jiahui, Consultant, Infectious Disease Service, KKH.

“Strict hygiene compliance when caring for children with diarrhoea is important as SARS-CoV2 virus has been detected in stools although currently there is no clear evidence of transmission from exposure to contaminated stool,” adds co-author, Dr Yung Chee Fu, Consultant, Infectious Disease Service, KKH.


High Proportion of Asymptomatic Cases in Children

“Approximately four in 10 children with COVID-19 did not show any symptoms throughout their illness. This makes it difficult to identify children with COVID-19 based on symptomatic testing alone,” shares Dr Li.

Adds Dr Yung, “This important finding underscores the importance of early screening and isolation of children upon detection of potential exposure to an index case of COVID-19.”


Symptomatic Children Did Not Have a Poorer Outcome

“Fortunately, we found that symptomatic children did not have a poorer outcome compared to asymptomatic children. None reported shortness of breath or chest discomfort, and none developed tachypnoea, tachycardia, hypotension or signs suggestive of Kawasaki disease during their illness.”

All 39 children were eventually discharged well, with a mean length of hospital stay of 15 days.

Read the full study here.



  1. J Li, KC Thoon, CY Chong, M Maiwald, K Kam, et al. Comparative analysis of symptomatic and asymptomatic SARS-CoV-2 infection in children. Annals of the Academy of Medicine, Singapore 2020; 49:530-37.


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