Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis
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REVIEW
Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis JITENDRA MEENA,1 JAIVINDER YADAV,2 LOKESH SAINI,2 ARUSHI YADAV3 AND JOGENDER KUMAR2
From 1Departments of Pediatrics, All India Institute of Medical Sciences, New Delhi; 2Post Graduate Institute of Medical Education and Research, Chandigarh; and 3Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh; India. Correspondence to: Dr Jogender Kumar, Assistant Professor, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India. [email protected]. Objective: Knowledge about COVID-19 in children is limited due to the paucity of reported data. The pediatric age group comprises only less than 5% of total COVID-19 worldwide, therefore, large studies in this population are unlikely in the immediate future. Hence, we planned to synthesize the current data that will help in a better understanding of COVID-19 in children.
Results: 27 studies (4857 patients) fulfilling the eligibility criteria were included in this systematic review, from a total of 883 records. About half of the patients had each of fever and cough, 11% (6-17%) had fast breathing, and 6-13% had gastrointestinal manifestations. Most of the patients had mild to moderate disease, and only 4% had a severe or critical illness. Leukopenia was the commonest reported laboratory abnormality.
Evidence acquisition: Four different electronic databases (MEDLINE, EMBASE, Web of Science, and CENTRAL) were searched for articles related to COVID-19 in the pediatric population. We included studies reporting disease characteristics and outcomes of COVID-19 in patients aged less than 19 years. We performed a random-effect meta-analysis to provide pooled estimates of various disease characteristics.
Conclusion: Even among the symptomatic COVID-19 cases, severe manifestations are seen in very few children. Though fever and respiratory symptoms are most common, many children also have gastrointestinal manifestations. Keywords: COVID-19, Gastrointestinal symptoms, Mortality, Severity. Published online: June 24, 2020; PII: S097475591600203
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METHODS
ith the rapidly evolving severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) pandemic, the knowledge about the disease manifestations and severity has also evolved quickly. Due to its resemblance to SARS, influenza, and other respiratory viruses, children were initially thought to be more susceptible than adults. However, less than 5% of total coronavirus disease (COVID-19) cases belong to the pediatric age group, and the severity has been milder as compared to adults [3,4]. Information regarding clinical manifestations and outcomes of COVID-19 in adults is available due to a huge number of reported cases, but the scenario for the pediatric population is different as our knowledge about clinical and laboratory characteristics as well as prognosis of COVID-19 is very limited.
We performed this systematic review to describe the currently av
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