{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:19:36Z","timestamp":1768216776309,"version":"3.49.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objectives<\/jats:title>\n This study examines age and geographic disparities in COVID-19 outcomes among Chinese children aged 0\u20136 years during China's rapid policy transition (December 2022\u2013January 2023), and evaluates the protective role of parental caregiving practices.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional online survey leveraging a natural experiment during China's COVID-19 policy shift. Data were collected from 48,332 households through randomized national sampling, stratified by urban\/rural and North\/South residency. Chi-square tests (SPSS 22.0) and latent class analysis (Mplus 7.0) assessed disparities in infection status, symptom severity, healthcare access, and medication use, alongside parental response patterns.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Age-mediated disparities: Significant gradients in infection rates (\u03c7\n 2<\/jats:sup>\n = 30.060,\n p<\/jats:italic>\n &lt; 0.001), symptom severity (\u03c7\n 2<\/jats:sup>\n = 20.626,\n p<\/jats:italic>\n &lt; 0.001), and healthcare access (\u03c7\n 2<\/jats:sup>\n = 90.876,\n p<\/jats:italic>\n &lt; 0.001), with children aged 3\u20136 experiencing milder outcomes than infants (0\u20131 years) and toddlers (1\u20133 years). Geospatial inequities: Urban-rural gaps in infections (\u03c7\n 2<\/jats:sup>\n = 58.713,\n p<\/jats:italic>\n &lt; 0.001) and North-South disparities in medication use (\u03c7\n 2<\/jats:sup>\n = 71.160,\n p<\/jats:italic>\n &lt; 0.001), with urban northern children most vulnerable. Parental buffering effects: Parents have exhibited a notably proactive stance and practices in response to the COVID-19 pandemic.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n COVID-19 infections in children vary by age and region, with parents playing a crucial role in home-based care. Policy responses should prioritize (1) parent-led protection programs and (2) targeted medical resource allocation to high-risk regions to ensure equitable pandemic recovery.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1696218","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:19:25Z","timestamp":1768205965000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Age and geographic heterogeneity in COVID-19 outcomes among young children and parental practices in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Beilei","family":"Zang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongfang","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinyan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 among children in China","volume":"145","author":"Dong","year":"2020","journal-title":"Pediatrics."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1093\/cid\/ciaa198","article-title":"A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features","volume":"71","author":"Jiehao","year":"2020","journal-title":"Clin Infect Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1056\/NEJMc2007617","article-title":"Children with Covid-19 in pediatric emergency departments in Italy","volume":"383","author":"Parri","year":"2020","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"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","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"B6","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s12519-020-00344-6","article-title":"Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement","volume":"16","author":"Shen","year":"2020","journal-title":"World J Pediatr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s12020-022-03266-7","article-title":"Covid-19 infection in children and adolescents and its association with type 1 diabetes mellitus (T1d) presentation and management","volume":"80","author":"Karavanaki","year":"2023","journal-title":"Endocrine."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.33263\/LIANBS93.11561164","article-title":"An epidemiological characteristic of the COVID-19 among children","volume":"9","author":"Alsayed","year":"2020","journal-title":"Lett Appl Nanobiosci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.ijid.2021.05.073","article-title":"Clinical and epidemiological characteristics of children with COVID-19 in Negeri Sembilan, Malaysia","volume":"108","author":"Ng","year":"2021","journal-title":"Int J Infect Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1111\/jpc.15791","article-title":"COVID-19 in children: I. 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