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A Systematic Review of Characteristics Associated with COVID-19 in Children with Typical Presentation and with
Jeffrey Kornitzer1,2, Jacklyn Johnson2, Max Yang3
1Division of Neurology, New Jersey Pediatric Neuroscience Institute (NJPNI), Morristown, NJ 07960, USA.
Insights
COVID-19 presents differently in children, with fever and sore throat being common. Multisystem Inflammatory Syndrome in Children (MIS-C) is associated with inflammatory and gastrointestinal symptoms, not respiratory ones.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) presents with varied severity in children.
- Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious complication of COVID-19 in pediatric populations.
Purpose of the Study:
- To systematically review the clinical spectrum of COVID-19 in children.
- To identify characteristics associated with MIS-C in pediatric COVID-19 cases.
Main Methods:
- Systematic literature review of English and Chinese articles.
- Searched databases: COVIDSeer, MEDLINE, PubMed (Jan 2020 - Mar 2021).
- Included 54 studies with 4811 pediatric patients.
Main Results:
- Fever and sore throat were the most common symptoms overall.
- 11.29% of pediatric patients (543/4811) developed MIS-C.
- MIS-C patients showed fewer respiratory symptoms but more inflammatory and gastrointestinal symptoms.
Conclusions:
- Children with COVID-19 can present with a wide range of symptoms.
- Inflammatory and GI symptoms in pediatric COVID-19 cases may indicate MIS-C.
- Early evaluation for MIS-C is recommended for children with these symptoms.
Abstract:
Setting off a global pandemic, coronavirus disease 2019 (COVID-19) has been marked by a heterogeneous clinical presentation that runs the gamut from asymptomatic to severe and fatal. Although less lethal in children than adults, COVID-19 has nonetheless afflicted the pediatric population. This systematic review used clinical information from published literature to assess the spectrum of COVID-19 presentation in children, with special emphasis on characteristics associated with multisystem inflammatory syndrome (MIS-C). An electronic literature search for English and Chinese language articles in COVIDSeer, MEDLINE, and PubMed from 1 January 2020 through 1 March 2021 returned 579 records, of which 54 were included for full evaluation. Out of the total 4811 patients, 543 (11.29%) exhibited MIS-C. The most common symptoms across all children were fever and sore throat. Children presenting with MIS-C were less likely to exhibit sore throat and respiratory symptoms (i.e., cough, shortness of breath) compared to children without MIS-C. Inflammatory (e.g., rash, fever, and weakness) and gastrointestinal (e.g., nausea/vomiting and diarrhea) symptoms were present to a greater extent in children with both COVID-19 and MIS-C, suggesting that children testing positive for COVID-19 and exhibiting such symptoms should be evaluated for MIS-C.
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