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Clinical manifestations and outcomes of COVID-19 in the paediatric population: a systematic review
M Jahangir1, M Nawaz1, D Nanjiani1
1Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Insights
Children with coronavirus disease 2019 (COVID-19) generally experience milder symptoms and have a better prognosis than adults. However, pediatric cases can be a hidden source of infection and may lead to severe pneumonia, especially with comorbidities.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has led to a global pandemic.
- Understanding COVID-19's impact on pediatric populations is crucial for public health strategies.
- Paediatric cases present unique challenges in diagnosis and transmission dynamics.
Purpose of the Study:
- To analyze the distribution, prevalence, and clinical characteristics of COVID-19 in patients aged 0-19 years.
- To evaluate clinical outcomes in neonates and paediatric patients with COVID-19.
- To assess the role of children in community transmission and identify risk factors.
Main Methods:
- A systematic literature review was performed using the Medline database.
- Searched for papers published between December 1, 2019, and April 9, 2020, focusing on COVID-19 in paediatric populations.
- Included scientific papers and letters detailing clinical, radiological, and laboratory findings.
Main Results:
- COVID-19 prevalence in children is low, with generally milder symptoms and better prognosis compared to adults.
- Severe pneumonia can occur in children, particularly those with comorbidities.
- Children may act as a hidden source of infection due to atypical presentations, contributing to community transmission.
Conclusions:
- COVID-19 presentation in children is typically milder than in adults, with a better overall prognosis.
- Limited evidence exists regarding intrauterine vertical transmission, necessitating further research.
- Supportive treatment remains the primary management strategy in the absence of specific vaccines or antivirals.
Objective:
Coronavirus disease 2019 (COVID-19), the respiratory illness caused by severe acute respiratory syndrome coronavirus 2, has affected hundreds of thousands of people. We aim to report the distribution of cases, prevalence, and clinical, radiological, and laboratory signs and outcomes of COVID-19 in paediatric patients. Moreover, we intend to evaluate neonatal clinical outcomes. Hence, our age range of interest is 0 to 19 years.
Methods:
A systematic literature review was conducted using the Medline database to identify papers published between 1 December 2019 and 9 April 2020 on COVID-19.
Results:
The search identified 27 relevant scientific papers and letters. The review showed that the prevalence of COVID-19 in the paediatric population accounts for a small percentage of patients, whose clinical signs and symptoms are often milder than those of adults. Despite better prognosis and low mortality in children, the disease can progress to severe pneumonia in some cases, especially in the presence of co-morbidities. Children are likely to become a hidden source of infection because of their atypical presentation, and they may play a role in community transmission, leading to unfavourable outcomes. There is little evidence about intrauterine vertical transmission. As no vaccine or specific antiviral is currently available, management plans include supportive treatment.
Conclusion:
As compared with that in adults, the presentation of COVID-19 in children is mild and has a better prognosis. Sufficient evidence regarding the probability of intrauterine vertical transmission could not be found, and further studies need to be conducted to establish this relationship.
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