Epidemiology of paediatric Middle East respiratory syndrome coronavirus and implications for the control of coronavirus virus disease 2019

Aim To compare the clinical features of Middle East respiratory syndrome coronavirus (MERS-CoV) infection between paediatric and adult cases Methods Using multiple public data sources, we created an enhanced open-source surveillance dataset of all MERS-CoV cases between 20 September 2012 and 31 December 2018 in Saudi Arabia including available risk factor data Results Of the 1791 cases of MERS-CoV identified, 30 cases (1 7%) were aged under 18?years and 1725 cases (96 3%) were aged 18?years and over Three paediatric cases were fatal, aged 0, 2 and 15?years The odds of asymptomatic MERS-CoV infection among cases under 18?years (n = 10/23;44%) was significantly higher (odds ratio (OR) = 4 98;95% confidence interval (CI): 2 15?11 51;P = 0 001) compared to adults (n = 199/1487;13%) The odds of hospitalisation were significantly lower (OR = 0 17;95% CI: 0 08?0 39;P