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Epidemiological, clinical and biomarker profile of pediatric patients infected with COVID-19
K Shah1, M Upadhyaya2, Y Kandre1
1Department of Public Health, Indian Institute of Public Health Gandhinagar, Opp. Air Force Head Quarters, Nr. Lekawada Bus Stop, Gandhinagar-Chiloda Road, Gandhinagar, Gujarat 382042, India.
Insights
COVID-19 in children is generally milder, with a low mortality rate of 0.12%. This umbrella review summarizes key characteristics to inform pediatric public health policies and identify at-risk youth.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Limited and diverse literature on pediatric COVID-19 necessitates evidence-based summaries.
- Essential for guiding policy decisions regarding children's health during the pandemic.
Purpose of the Study:
- To provide a comprehensive overview of the epidemiological, clinical, and biomarker profiles of COVID-19 in the pediatric population.
- To synthesize existing evidence for informing public health strategies.
Main Methods:
- An umbrella review methodology was employed, screening systematic reviews from PubMed and pre-print databases (December 2019 - April 2021).
- Data on clinical, radiological, and laboratory features were extracted and synthesized.
- Meta-analysis was used to determine the pooled prevalence of mortality and asymptomatic cases.
Main Results:
- The review synthesized 38 systematic reviews encompassing 1145 studies and 334,398 children and adolescents.
- COVID-19 presents with milder disease and better prognosis in pediatrics, though comorbidities increase risk.
- Asymptomatic cases were prevalent (21.17%), with a low mortality rate (0.12%). Common symptoms included fever and cough; ground-glass opacities were frequent radiographic findings. Elevated inflammatory markers were observed.
Conclusions:
- This umbrella review offers updated information on pediatric COVID-19 characteristics.
- Findings can guide policy decisions on vaccination prioritization, early screening, and identification of at-risk pediatric populations.
Background:
Given the limited and diverse nature of published literature related to COVID-19 in pediatrics, it is imperative to provide evidence-based summary of disease characteristics for guiding policy decisions. We aim to provide comprehensive overview of epidemiological, clinical and biomarker profile of COVID-19 infection in pediatric population.
Methods:
For this umbrella review, published systematic reviews from PubMed and pre-print databases were screened. Literature search was conducted from December 2019 to April 2021. Details of clinical, radiological and laboratory features were collected from each review. Qualitative observations were synthesized and pooled prevalence of mortality and asymptomatic cases were assessed using meta-analysis.
Results:
Evidence synthesis of 38 systematic reviews included total 1145 studies and 334 398 children and adolescents. Review revealed that COVID-19 is relatively milder with better prognosis in pediatrics. However, patients with comorbidity are at higher risk. Meta-analysis of reviews showed that 21.17% (95% CI: 17.818-24.729) of the patients were asymptomatic and mortality rate was 0.12% (95% CI: 0.0356-0.246). Though there was no publication bias, significant heterogeneity was observed. Fever (48-64%) and cough (35-55.9%) were common symptoms, affecting almost every alternate patient. Ground-glass opacities (prevalence range: 27.4-61.5%) was most frequent radiographic observation. Rise in C-reactive protein, lactate dehydrogenase and D-dimer ranged from 14% to 54%, 12.2-50% and 0.3-67%, respectively. Some of the included reviews (44.7%-AMSTAR; 13.2%-GRADE) were of lower quality.
Conclusion:
Current umbrella review provides most updated information regarding characteristics of COVID-19 infection in pediatrics and can be used to guide policy decision regarding vaccination prioritization, early screening and identification of at-risk population.
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