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COVID-19 in Pediatrics: A Systematic Review of Current Knowledge and Practice
Esmaeil Mehraeen1, Shahram Oliaei2, SeyedAhmad SeyedAlinaghi3
1Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran.
Insights
Children infected with SARS-CoV-2 (the virus that causes COVID-19) often have mild symptoms and can be silent carriers. This systematic review highlights the clinical aspects and public health implications of COVID-19 in pediatric populations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- SARS-CoV-2 causes COVID-19, a global health concern.
- Children typically present with mild or asymptomatic SARS-CoV-2 infections, posing challenges for diagnosis and disease control.
- Understanding COVID-19 in children is crucial for public health strategies.
Purpose of the Study:
- To conduct a comprehensive systematic review of the current knowledge on COVID-19 in children.
- To reflect on the clinical and paraclinical aspects of SARS-CoV-2 infection in pediatric populations.
- To inform current practices regarding pediatric COVID-19 management.
Main Methods:
- Systematic review of literature published up to October 2020.
- Systematic search of online databases using relevant keywords.
- Adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for quality assurance.
Main Results:
- 23 studies were selected from 1744 initial papers.
- The majority of publications originated from China, but data from multiple countries were included.
- Children can experience systemic involvement and various symptoms, though generally less severe than in adults.
Conclusions:
- COVID-19 in children can manifest with systemic involvement, but prevalence and severity are lower than in adults.
- Common symptoms include cough and fever; gastrointestinal issues and comorbidities can also occur.
- Mental health impacts, such as anxiety and depression, are significant in children during the pandemic and require clinical attention.
Introduction:
SARS-CoV-2 is the novel coronavirus that causes severe acute respiratory syndrome and could afflict individuals from all walks of life. Children are usually asymptomatic or represent non-specific mild to moderate symptoms; therefore, they often remain undiagnosed and could be potential reservoirs and silent carriers of the virus. Despite the global attention to COVID-19 and its importance in public health, some clinical and paraclinical aspects of this disease in children are still unclear. Thus, we conducted a comprehensive systematic review of available literature to reflect on the current knowledge and practice of the disease among children.
Methods:
This study was a systematic review of current evidence conducted in October 2020. We performed a systematic search using the keywords in online databases. The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of extracted literature and results.
Results:
We selected and reviewed 23 most related studies out of 1744 identified papers in an initial online search based on the inclusion and exclusion criteria of the present review; of whom 13 were original research studies, and 10 were letters to the editors, commentaries, viewpoints, consensus statements, and perspectives. Although due to the origin of the current pandemic, China was the country with the most publications (12 articles), data from several countries have been included in this review.
Conclusion:
COVID-19 can also affect children and cause systemic disease with several internal organ involvements. However, the prevalence, severity, and diversity of the symptoms in children are less than in adults. Cough and fever appear to be some of the most common symptoms, followed by other symptoms such as gastrointestinal manifestations. Comorbidities increase the risk of severe COVID-19 in children, and those without underlying conditions are very unlikely to suffer from severe disease. Mental health issues such as anxiety and depression due to the isolated situation caused by pandemics are common findings in children of early ages and should be seriously considered in current practice.
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