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COVID-19 in the Pediatric Population-Review and Current Evidence
Shira Rabinowicz1,2, Eyal Leshem2,3, Itai M Pessach1,2
1The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ministry of Health, Tel Hashomer, Ramat Gan, Israel.
Insights
Children generally experience milder coronavirus disease 2019 (COVID-19) with lower incidence than adults. However, a rare complication, multisystem inflammatory syndrome (MIS), can cause critical illness in pediatric patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- The coronavirus disease 2019 (COVID-19) pandemic has caused significant global health and economic disruptions.
- Understanding COVID-19 disease characteristics in children is crucial for public health management.
Purpose of the Study:
- To review the characteristics of COVID-19 disease in pediatric populations.
- To identify risk factors for severe disease and associated complications in children.
Main Methods:
- This review synthesizes current data on COVID-19 in children.
- Analysis includes epidemiological data, clinical manifestations, and outcomes.
Main Results:
- Children represent 1-2% of diagnosed COVID-19 cases, typically with mild symptoms like fever, cough, and respiratory or gastrointestinal issues.
- A notable proportion (4-23%) of infected children are asymptomatic. Risk factors for severe disease include neonatal age, male gender, lower respiratory tract involvement, and pre-existing conditions.
- Multisystem inflammatory syndrome (MIS) is a rare but severe complication in children, characterized by fever and multi-organ involvement. Indirect effects include increased psychiatric issues and neglect.
Conclusions:
- COVID-19 incidence and severity are generally lower in children compared to adults.
- Multisystem inflammatory syndrome (MIS) is a critical concern in pediatric COVID-19 cases.
- Further research is needed on antiviral efficacy and safety in children.
Purpose Of Review:
Coronavirus disease 2019 (COVID-19) pandemic has major health and economic impacts. We review disease characteristics in children.
Recent Findings:
Children comprise 1-2% of the diagnosed cases, and typically suffer mild disease. The median age of infected children is 3.3-11 years, and male/female ratio is 1.15-1.55. Common symptoms in children include upper respiratory symptoms (26-54%), cough (44-54%), fever (32-65%), and gastrointestinal (15-30%) symptoms. Substantial proportion (4-23%) are asymptomatic. Death rates are up to 0.7%. Risk factors associated with severe disease are neonatal age group, male gender, lower respiratory tract disease, and pre-existing medical conditions. Vertical transmission was reported. Multisystem inflammatory syndrome (MIS), characterized by fever, multisystem organ involvement, and laboratory markers of inflammation, causes critical illness in > 50% of cases and is increasingly reported from endemic countries. Indirect effects of the coronavirus epidemic include higher rates of psychiatric morbidities, education loss, unhealthy lifestyle changes, and increased child neglect. Vaccines are in clinical trials and immunogenicity has not yet been shown in children.
Summary:
Overall, COVID-19 has lower incidence and causes milder disease in children compared with adult patients. MIS is a rare severe complication more common in children. More data on the efficacy and safety of antivirals in children are needed.
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