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BMC Pediatr . Children with COVID-19 behaving milder may challenge the public policies: a systematic review and meta-analysis

tetano

Editor, Senior Moderator
BMC Pediatr


. 2020 Sep 1;20(1):410.
doi: 10.1186/s12887-020-02316-1.
Children with COVID-19 behaving milder may challenge the public policies: a systematic review and meta-analysis


Chan Liu[SUP] 1 [/SUP], Yu He[SUP] 1 [/SUP], Lian Liu[SUP] 1 [/SUP], Fang Li[SUP] 2 [/SUP], Yuan Shi[SUP] 3 [/SUP]



Affiliations

Abstract

Background: The emerging virus is rampaging globally. A growing number of pediatric infected cases have been reported. Great efforts are needed to cut down the transmission.
Methods: A single-arm meta-analysis was conducted. We searched PubMed, Google Scholar, Web of Science, and several Chinese databases for studies presenting characteristics of children confirmed with Coronavirus Disease 2019 (COVID-19) from December 12, 2019 to May 10, 2020. Quality Appraisal of Case Series Studies Checklist was used to assess quality and publication bias was analyzed by Egger's test. Random-effect model was used to calculate the pooled incidence rate (IR) or mean difference (MD) with 95% confidence intervals (CI), or a fixed model instead when I[SUP]2[/SUP] < 50%. We conducted subgroup analysis according to geographic region. Additionally, we searched United Nations Educational Scientific and Cultural Organization to see how different countries act to the education disruption in COVID-19.
Results: 29 studies with 4300 pediatric patients were included. The mean age was 7.04 (95% CI: 5.06-9.08) years old. 18.9% of children were asymptomatic (95% CI: 0.121-0.266), 37.4% (95% CI: 0.280-0.474) had no radiographic abnormalities. Besides, a proportion of 0.1% patients were admitted to intensive care units (0, 95% CI: 0.000-0.013) and four deaths were reported (0, 95% CI: 0.000-0.000). Up to 159 countries have implemented nationwide school closures, affecting over 70% of the world's students.
Conclusion: Children were also susceptible to SARS-CoV-2, while critical cases or deaths were rare. Characterized by mild presentation, the dilemma that children may become a potential spreader in the pandemic, while strict managements like prolonged school closures, may undermine their well-beings. Thus, the public policies are facing challenge.

Keywords: COVI-19; Children; Meta-analysis; SARS-CoV-2; School closure.
 
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