The recent novel coronavirus outbreak was first detected in Wuhan, China in late December 2019. By July. 2020, it has spread to 216 countries and territories, resulting in over 12 million confirmed cases and fifty-five thousand deaths [1–2]. This new pandemic was officially determined by World Health Organization (WHO) to be an novel coronavirus disease (abbreviated as COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) . Where infection rate is concerned, young children seem to be less susceptible to COVID-19 infection than adults; additionally, children with COIVD-19 became less ill and demonstrated less obvious symptom and classic . Current investigations have confirmed that SARS-CoV‐2 enters cells by binding to the angiotensin‐converting enzyme 2 (ACE‐2) cell receptor and facilitate internalization of the virus into human cells. That may explain this different infection rate between adults and children because of low ACE2 expression in children [3–5].
However, evidence has proved children can get COVID-19 like adults, and pediatric COVID-19 cases are now gradually increasing in different countries [6–9]. The most common clinical manifestations of pediatric cases are fever, cough, or shortness of breath (over 60%) followed by headache (15% in 0–9 year old pediatric patients, 42% in 10–19 year old pediatric patients) [7–8]. According to clinical characteristics of existing pediatric cases, children with COVID-19 can be divided into five clinical types: asymptomatic infection, mild, common, severe, and critically severe [8–10]. In comparison adult patients, most children diagnosed with the disease experience mild symptoms, faster recovery, shorter detoxification time, and good prognosis [8–9]. However, a rare new serious multisystem inflammatory syndrome, related to COVID-19 and apparently caused by overactive immune responses in old children and adolescents, can occur, and the number of these atypical cases in pediatric patients has been increasing since the middle of April. 2020 in Europe, Canada, and the United States [11–12].
COVID-19 is highly contagious and transmits mainly from person-to-person contact with respiratory droplets of an infected person and usually through coughing and sneezing [13–16]. Currently, experts believe that SARS-CoV‐2 can be transmitted through direct, indirect, or close contact with infected secretions (saliva, respiratory droplets, eye discharge, feces or urine) [17–18]. Infection can occur by multiple routes including contact and droplet transmission, touch contaminated surfaces and objects (Fomite transmission), aerosols transmission, fecal-oral, and waterborne routes [14–17]. WHO has acknowledged that the coronavirus can be spread by tiny particles suspended in the air [16–17]. A South Korea’s study found that children, younger than 10, transmit COVID-19 to others much less often than adults do; however, children, between 10–19 years old seemed to transmit the virus as well as adults do . This research, conducted during school closure, also found that the highest COVID-19 rate in school-aged children and the lowest for household contacts of children 0–9 years . In contract, an investigation in Wuhan and Shanghai, China, found that school closures and social distancing significantly reduced COVID-19 rates among school-age children .
Based on above research, personal protective measures, personal hygiene, and appropriate social distance remain the most viable options for prevention among children [6, 19, 21–26]. In recent months schools around the world have gradually begun to reopen, including in most provinces in China, causing many parents to fear for their children’s safety in the midst of a pandemic. To keep students safe, self-protection measures, educational facilities and outreach are particularly important; therefore, parental awareness regarding COVID-19 must first be evaluated. As schools reopen in China and around the world, such studies will be essential to a safe reopening process. The aim of this research was to investigate the awareness of parents regarding pediatric COVID-19 in relation to protecting their children.