tetano
Editor, Senior Moderator
Pediatr Pulmonol
. 2020 Jul 29.
doi: 10.1002/ppul.24991. Online ahead of print.
Clinical characteristics of COVID-19 in children: a systematic review
Jun Yasuhara[SUP] 1 [/SUP], Toshiki Kuno[SUP] 2 [/SUP], Hisato Takagi[SUP] 3 [/SUP], Naokata Sumitomo[SUP] 4 [/SUP]
Affiliations
Abstract
Background: Limited pediatric cases with coronavirus disease 2019 (COVID-19) have been reported and the clinical profiles regarding COVID-19 in children remain obscure. Our aim was to investigate the clinical characteristics of COVID-19 in children.
Methods: PUBMED and EMBASE were searched through June 20, 2020, for case reports and case series reporting pediatric COVID-19 cases. Epidemiological, clinical, laboratory, and radiological data were collected and analyzed to compare by age.
Results: Our search identified 46 eligible case reports and case series. A total of 114 pediatric cases with COVID-19 were included. The main clinical features were mild symptoms including fever (64%), cough (35%), and rhinorrhea (16%), or no symptoms (15%). Ground-like opacities were common radiological findings (54%). The main laboratory findings were lymphopenia (33%) and elevated D-dimer (52%) and C-reactive protein (40%) levels. We identified 17 patients (15%) with multisystem inflammatory syndrome in children (MIS-C) manifesting with symptoms overlapping with, but distinct from, Kawasaki disease, including gastrointestinal symptoms, left ventricular systolic dysfunction, shock, and marked elevated inflammatory biomarkers. Twelve percent of the patients including 65% of the MIS-C cases required intensive care because of hypotension. No deaths were reported.
Conclusion: This systematic review found that children with COVID-19 are generally less severe or asymptomatic. However, infants might be seriously ill and older children might develop MIS-C with severe illness. Early detection of children with mild symptoms or an asymptomatic state and early diagnosis of MIS-C are mandatory for the management of COVID-19 and the prevention of transmission and a severe inflammatory state. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Kawasaki disease; SARS-CoV-2; clinical features; multisystem inflammatory syndrome in children (MIS-C).
. 2020 Jul 29.
doi: 10.1002/ppul.24991. Online ahead of print.
Clinical characteristics of COVID-19 in children: a systematic review
Jun Yasuhara[SUP] 1 [/SUP], Toshiki Kuno[SUP] 2 [/SUP], Hisato Takagi[SUP] 3 [/SUP], Naokata Sumitomo[SUP] 4 [/SUP]
Affiliations
- PMID: 32725955
- DOI: 10.1002/ppul.24991
Abstract
Background: Limited pediatric cases with coronavirus disease 2019 (COVID-19) have been reported and the clinical profiles regarding COVID-19 in children remain obscure. Our aim was to investigate the clinical characteristics of COVID-19 in children.
Methods: PUBMED and EMBASE were searched through June 20, 2020, for case reports and case series reporting pediatric COVID-19 cases. Epidemiological, clinical, laboratory, and radiological data were collected and analyzed to compare by age.
Results: Our search identified 46 eligible case reports and case series. A total of 114 pediatric cases with COVID-19 were included. The main clinical features were mild symptoms including fever (64%), cough (35%), and rhinorrhea (16%), or no symptoms (15%). Ground-like opacities were common radiological findings (54%). The main laboratory findings were lymphopenia (33%) and elevated D-dimer (52%) and C-reactive protein (40%) levels. We identified 17 patients (15%) with multisystem inflammatory syndrome in children (MIS-C) manifesting with symptoms overlapping with, but distinct from, Kawasaki disease, including gastrointestinal symptoms, left ventricular systolic dysfunction, shock, and marked elevated inflammatory biomarkers. Twelve percent of the patients including 65% of the MIS-C cases required intensive care because of hypotension. No deaths were reported.
Conclusion: This systematic review found that children with COVID-19 are generally less severe or asymptomatic. However, infants might be seriously ill and older children might develop MIS-C with severe illness. Early detection of children with mild symptoms or an asymptomatic state and early diagnosis of MIS-C are mandatory for the management of COVID-19 and the prevention of transmission and a severe inflammatory state. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Kawasaki disease; SARS-CoV-2; clinical features; multisystem inflammatory syndrome in children (MIS-C).