Clinical characteristics and diagnostic challenges of pediatric COVID-19: A systematic review and meta-analysis
Journal
Journal of the Formosan Medical Association
Journal Volume
119
Journal Issue
5
Pages
982-989
Date Issued
2020
Author(s)
Abstract
Background/Purpose: Current studies on pediatric coronavirus disease 2019 (COVID-19) are rare. The clinical characteristics and spectrum are still unknown. Facing this unknown and emerging pathogen, we aimed to collect current evidence about COVID-19 in children. Methods: We performed a systematic review in PubMed and Embase to find relevant case series. Because some reports were published in Chinese journals, the journals and publications of the Chinese Medical Association related to COVID-19 were completely reviewed. A random effects model was used to pool clinical data in the meta-analysis. Results: Nine case series were included. In the pooled data, most of patients (75%) had a household contact history. The disease severity was mainly mild to moderate (98%). Only 2 children (2%) received intensive care. Fever occurred in 59% of the patients, while cough in 46%. Gastrointestinal symptoms (12%) were uncommon. There are 26% children are asymptomatic. The most common radiographic finding was ground glass opacities (48%). Currently, there is no evidence of vertical transmission to neonates born to mothers with COVID-19. Compared with the most relevant virus, SARS-CoV, SARS-CoV-2 causes less severe disease. Conclusion: COVID-19 has distinct features in children. The disease severity is mild. Current diagnosis is based mainly on typical ground glass opacities on chest CT, epidemiological suspicion and contact tracing. ? 2020
SDGs
Other Subjects
Article; child; clinical feature; clinical study; comparative study; contact examination; coronavirus disease 2019; coughing; disease severity; fever; gastrointestinal symptom; household; human; intensive care; lymphocytopenia; meta analysis; mother; newborn; severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; systematic review; thorax radiography; Betacoronavirus; Coronavirinae; Coronavirus infection; coughing; diagnostic imaging; fever; genetics; isolation and purification; laboratory technique; lung; pandemic; polymerase chain reaction; procedures; severity of illness index; virus pneumonia; x-ray computed tomography; Betacoronavirus; Child; Clinical Laboratory Techniques; Contact Tracing; Coronavirus; Coronavirus Infections; Cough; Fever; Humans; Lung; Pandemics; Pneumonia, Viral; Polymerase Chain Reaction; Severity of Illness Index; Tomography, X-Ray Computed
Publisher
Elsevier B.V.
Type
journal article