tetano
Editor, Senior Moderator
J Med Virol
. 2020 Aug 6.
doi: 10.1002/jmv.26398. Online ahead of print.
A systematic review and meta-analysis of children with Coronavirus Disease 2019 (COVID-19)
Xiaojian Cui[SUP] 1 [/SUP], Zhihu Zhao[SUP] 2 [/SUP], Tongqiang Zhang[SUP] 3 4 [/SUP], Wei Guo[SUP] 3 [/SUP], Wenwei Guo[SUP] 1 [/SUP], Jiafeng Zheng[SUP] 3 [/SUP], Jiayi Zhang[SUP] 1 [/SUP], Cuicui Dong[SUP] 1 [/SUP], Ren Na[SUP] 1 [/SUP], Lisheng Zheng[SUP] 1 [/SUP], Wenliang Li[SUP] 1 [/SUP], Zihui Liu[SUP] 1 [/SUP], Jia Ma[SUP] 1 [/SUP], Jinhu Wang[SUP] 5 [/SUP], Sijia He[SUP] 6 [/SUP], Yongsheng Xu[SUP] 3 [/SUP], Ping Si[SUP] 1 [/SUP], Yongming Shen[SUP] 1 [/SUP], Chunquan Cai[SUP] 7 8 9 [/SUP]
Affiliations
Abstract
Objective: To provide a comprehensive and systematic analysis of demographic characteristics, clinical symptoms, laboratory findings and imaging features of coronavirus disease 2019 (COVID-19) in pediatric patients.
Methods: A meta-analysis was carried out to identify studies on COVID-19 from December 25, 2019 to April 30, 2020.
Results: A total of 48 studies with 5829 pediatric patients were included. Children at all ages were at risk for COVID-19. The main illness classification ranged as: 20% (95% CI: 14 to 26%, I[SUP]2[/SUP] =91.4%) asymptomatic, 33% (95% CI: 23 to 43%, I[SUP]2[/SUP] =95.6%) mild and 51% (95% CI: 42 to 61%, I[SUP]2[/SUP] =93.4%) moderate. The typical clinical manifestations were fever 51% (95% CI: 45 to 57%, I[SUP]2[/SUP] =78.9%) and cough 41% (95% CI: 35 to 47%, I[SUP]2[/SUP] =81.0%). The common laboratory findings were normal white blood cell 69% (95% CI: 64 to 75%, I[SUP]2[/SUP] =58.5%), lymphopenia 16% (95% CI: 11 to 21%, I[SUP]2[/SUP] =76.9%) and elevated creatine-kinase MB (CK-MB) 37% (95% CI: 25 to 48%, I[SUP]2[/SUP] =59.0%). The frequent imaging features were normal images 41% (95% CI: 30 to 52%, I[SUP]2[/SUP] =93.4%) and ground-glass opacity 36% (95% CI: 25 to 47%, I[SUP]2[/SUP] =92.9%). Among children under 1-year old, critical cases account for 14% (95% CI: 13 to 34%, I[SUP]2[/SUP] =37.3%) that should be of concern. In addition, vomiting occurred in 33% (95% CI: 18 to 67%, I[SUP]2[/SUP] =0.0%) cases that may also need attention.
Conclusions: Pediatric patients with COVID-19 may experience milder illness with atypical clinical manifestations and rare lymphopenia. High incidence of critical illness and vomiting symptoms reward attention in children under 1-year old. This article is protected by copyright. All rights reserved.
Keywords: 2019-nCoV; COVID-19; Children; SARS-CoV-2; coronavirus; meta-analysis.
. 2020 Aug 6.
doi: 10.1002/jmv.26398. Online ahead of print.
A systematic review and meta-analysis of children with Coronavirus Disease 2019 (COVID-19)
Xiaojian Cui[SUP] 1 [/SUP], Zhihu Zhao[SUP] 2 [/SUP], Tongqiang Zhang[SUP] 3 4 [/SUP], Wei Guo[SUP] 3 [/SUP], Wenwei Guo[SUP] 1 [/SUP], Jiafeng Zheng[SUP] 3 [/SUP], Jiayi Zhang[SUP] 1 [/SUP], Cuicui Dong[SUP] 1 [/SUP], Ren Na[SUP] 1 [/SUP], Lisheng Zheng[SUP] 1 [/SUP], Wenliang Li[SUP] 1 [/SUP], Zihui Liu[SUP] 1 [/SUP], Jia Ma[SUP] 1 [/SUP], Jinhu Wang[SUP] 5 [/SUP], Sijia He[SUP] 6 [/SUP], Yongsheng Xu[SUP] 3 [/SUP], Ping Si[SUP] 1 [/SUP], Yongming Shen[SUP] 1 [/SUP], Chunquan Cai[SUP] 7 8 9 [/SUP]
Affiliations
- PMID: 32761898
- DOI: 10.1002/jmv.26398
Abstract
Objective: To provide a comprehensive and systematic analysis of demographic characteristics, clinical symptoms, laboratory findings and imaging features of coronavirus disease 2019 (COVID-19) in pediatric patients.
Methods: A meta-analysis was carried out to identify studies on COVID-19 from December 25, 2019 to April 30, 2020.
Results: A total of 48 studies with 5829 pediatric patients were included. Children at all ages were at risk for COVID-19. The main illness classification ranged as: 20% (95% CI: 14 to 26%, I[SUP]2[/SUP] =91.4%) asymptomatic, 33% (95% CI: 23 to 43%, I[SUP]2[/SUP] =95.6%) mild and 51% (95% CI: 42 to 61%, I[SUP]2[/SUP] =93.4%) moderate. The typical clinical manifestations were fever 51% (95% CI: 45 to 57%, I[SUP]2[/SUP] =78.9%) and cough 41% (95% CI: 35 to 47%, I[SUP]2[/SUP] =81.0%). The common laboratory findings were normal white blood cell 69% (95% CI: 64 to 75%, I[SUP]2[/SUP] =58.5%), lymphopenia 16% (95% CI: 11 to 21%, I[SUP]2[/SUP] =76.9%) and elevated creatine-kinase MB (CK-MB) 37% (95% CI: 25 to 48%, I[SUP]2[/SUP] =59.0%). The frequent imaging features were normal images 41% (95% CI: 30 to 52%, I[SUP]2[/SUP] =93.4%) and ground-glass opacity 36% (95% CI: 25 to 47%, I[SUP]2[/SUP] =92.9%). Among children under 1-year old, critical cases account for 14% (95% CI: 13 to 34%, I[SUP]2[/SUP] =37.3%) that should be of concern. In addition, vomiting occurred in 33% (95% CI: 18 to 67%, I[SUP]2[/SUP] =0.0%) cases that may also need attention.
Conclusions: Pediatric patients with COVID-19 may experience milder illness with atypical clinical manifestations and rare lymphopenia. High incidence of critical illness and vomiting symptoms reward attention in children under 1-year old. This article is protected by copyright. All rights reserved.
Keywords: 2019-nCoV; COVID-19; Children; SARS-CoV-2; coronavirus; meta-analysis.