• 1 Department of Paediatrics, Hospital Tuanku Ja'afar Seremban, Malaysia
  • 2 Department of Paediatrics, Perdana University-Royal College of Surgeons in Ireland School of Medicine, Seremban, Malaysia
  • 3 Microbiology Unit, Department of Pathology, Hospital Tuanku Ja'afar Seremban, Malaysia
  • 4 Hospital Rembau, Chembong, Malaysia
  • 5 Negeri Sembilan State Health Department, Seremban, Malaysia
  • 6 Department of Paediatrics, International Medical University, Seremban, Malaysia. Electronic address:
Int J Infect Dis, 2021 Jul;108:347-352.
PMID: 34087485 DOI: 10.1016/j.ijid.2021.05.073


OBJECTIVES: To describe the clinical and epidemiological characteristics of children with coronavirus disease 2019 (COVID-19) in the state of Negeri Sembilan, Malaysia in the setting of mandatory hospital isolation and quarantine for all confirmed cases.

METHODS: A multi-centre, retrospective observational study was performed among children aged ≤12 years with laboratory-proven COVID-19 between 1 February and 31 December 2020.

RESULTS: In total, 261 children (48.7% males, 51.3% females) were included in this study. The median age was 6 years [interquartile range (IQR) 3-10 years]. One hundred and fifty-one children (57.9%) were asymptomatic on presentation. Among the symptomatic cases, fever was the most common presenting symptom. Two hundred and forty-one (92.3%) cases were close contacts of infected household or extended family members. Twenty-one (8.4%) cases had abnormal radiological findings. All cases were discharged alive without requiring supplemental oxygen therapy or any specific treatment during hospitalization. The median duration of hospitalization was 7 days (IQR 6-10 days). One (2.1%) of the uninfected guardians accompanying a child in quarantine tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) upon discharge.

CONCLUSIONS: COVID-19 in children was associated with mild symptoms and a good prognosis. Familial clustering was an important epidemiologic feature in the outbreak in Negeri Sembilan. The risk of transmission of SARS-CoV-2 from children to guardians in hospital isolation was minimal despite close proximity.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.