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A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19)

Xiaojian Cui1, Zhihu Zhao2, Tongqiang Zhang3,4

  • 1Department of Clinical Lab, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, PR China.

Journal of Medical Virology
|August 8, 2020
PubMed

Insights

This meta-analysis reveals that children with coronavirus disease 2019 (COVID-19) often present with mild symptoms like fever and cough. Infants under one year old require special attention due to a higher incidence of critical illness and vomiting.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Coronavirus disease 2019 (COVID-19) affects children, necessitating a clear understanding of its presentation in this demographic.
  • Pediatric COVID-19 cases exhibit varied clinical, laboratory, and imaging features.
  • Systematic analysis is crucial for characterizing COVID-19 in pediatric populations.

Purpose of the Study:

  • To systematically analyze the demographic characteristics, clinical symptoms, laboratory findings, and imaging features of COVID-19 in pediatric patients.
  • To identify risk factors and common manifestations of COVID-19 in children.
  • To provide a comprehensive overview of pediatric COVID-19 for clinical guidance.

Main Methods:

  • A meta-analysis was conducted on 48 studies including 5829 pediatric patients diagnosed with COVID-19.
  • Data were collected from December 25, 2019, to April 30, 2020.
  • Statistical analysis focused on illness classification, clinical signs, lab results, and imaging features.

Main Results:

  • Children of all ages are susceptible to COVID-19, with 20% asymptomatic, 33% mild, and 51% moderate illness.
  • Common symptoms include fever (51%) and cough (41%).
  • Frequent laboratory findings were normal white blood cell count (69%) and ground-glass opacity on imaging (36%).
  • Children under 1 year old had a 14% critical case rate and 33% experienced vomiting, warranting close monitoring.

Conclusions:

  • Pediatric COVID-19 often presents with milder illness and atypical symptoms, including less frequent lymphopenia.
  • Infants under one year old represent a high-risk group requiring focused attention due to critical illness and vomiting.
  • Understanding these pediatric-specific features is vital for effective management and public health strategies.

Keywords:
2019-nCoVCOVID-19SARS-CoV-2childrencoronavirusmeta-analysis

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