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Clinical manifestations of children with COVID-19: A systematic review

Tiago H de Souza1, José A Nadal1, Roberto J N Nogueira1,2

  • 1Pediatric Intensive Care Unit, Department of Pediatrics, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Pediatric Pulmonology
|June 4, 2020
PubMed

Insights

Clinical features of coronavirus disease 2019 (COVID-19) in children vary from adults. Fever and respiratory symptoms are not always indicative of COVID-19 in pediatric cases.

Area of Science:

  • Pediatric Infectious Diseases
  • Public Health
  • Epidemiology

Background:

  • Coronavirus disease 2019 (COVID-19) presents a global health challenge.
  • Clinical characteristics of COVID-19 in children remain largely undefined.
  • Understanding pediatric COVID-19 is crucial for public health management.

Purpose of the Study:

  • To delineate the clinical, laboratorial, and radiological features of COVID-19 in pediatric patients.
  • To provide a comprehensive overview of disease presentation in children.
  • To inform clinical practice and public health strategies for pediatric COVID-19.

Main Methods:

  • Systematic literature search of Medline database (December 2019 - April 2020).
  • Inclusion of studies with pediatric patients (<18 years) confirmed positive for COVID-19 via RT-PCR.
  • Analysis of clinical manifestations, laboratory findings, and radiological examinations.

Main Results:

  • 38 studies encompassing 1124 pediatric cases were analyzed.
  • Most cases were asymptomatic (14.2%), mild (36.3%), or moderate (46.0%); severe (2.1%) and critical (1.2%) cases were rare.
  • Fever (47.5%) and cough (41.5%) were the most common symptoms; pneumonia was diagnosed in 36.9% of cases.
  • Computed tomography revealed abnormalities in 63.0% of cases, including ground-glass opacities and consolidations.

Conclusions:

  • Pediatric COVID-19 clinical presentation differs significantly from adult cases.
  • Fever and respiratory symptoms are not consistently defining characteristics of COVID-19 in children.
  • Further research is needed to fully characterize the spectrum of COVID-19 in pediatric populations.
Abstract

Keywords:
COVID-19SARS-CoV-2childrencoronavirus

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