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Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

Bingbing Li1, Shan Zhang1, Ruili Zhang1

  • 1Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China.

Frontiers in Pediatrics
|November 23, 2020
PubMed

Insights

Children infected with SARS-CoV-2 often show mild symptoms like fever and cough. This study highlights the importance of recognizing pediatric COVID-19 transmissibility due to prolonged virus shedding and incubation periods.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Epidemiology

Background:

  • Limited data exists on pediatric SARS-CoV-2 infections, necessitating urgent research into their epidemiological and clinical profiles.
  • Understanding the characteristics of COVID-19 in children is crucial for public health strategies and clinical management.

Approach:

  • A systematic review and meta-analysis was conducted, synthesizing data from 96 studies encompassing 7004 pediatric cases of SARS-CoV-2 infection.
  • International and Chinese public databases were systematically searched for case studies published between January 1, 2020, and May 7, 2020.

Key Points:

  • The mean age of infected children was 6.48 years, with 90% having household contact. Mild to moderate symptoms were observed in 66%, with fever (47%) and cough (42%) being most common. Asymptomatic cases accounted for 23% of the total.
  • The pooled mean incubation period was 9.57 days. Viral shedding in the upper respiratory tract lasted a mean of 11.43 days, and 75% of children had detectable virus particles in stool.
  • Hematological findings included neutropenia (34%) and lymphocytosis (26%). Interferon-alpha was the most frequently used antiviral (81%). Discharge and mortality rates were 79% and 1%, respectively.

Conclusions:

  • Pediatric COVID-19 transmissibility should not be underestimated due to factors like a relatively long incubation period and viral shedding duration.
  • Mild clinical presentations in children can mask significant epidemiological implications, emphasizing the need for continued surveillance and research.

Keywords:
SARS-CoV-2childrenclinical characteristicsepidemiologymeta-analysis

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