tetano
Editor, Senior Moderator
Pediatr Pulmonol
. 2020 Jun 3.
doi: 10.1002/ppul.24885. Online ahead of print.
Clinical Manifestations of Children With COVID-19: A Systematic Review
Tiago H de Souza[SUP] 1 [/SUP], Jos? A Nadal[SUP] 1 [/SUP], Roberto J N Nogueira[SUP] 1 2 [/SUP], Ricardo M Pereira[SUP] 1 [/SUP], Marcelo B Brand?o[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The coronavirus disease 2019 (COVID-19) outbreak is an unprecedented global public health challenge, leading to thousands of deaths every day worldwide. Despite the epidemiological importance, clinical patterns of children with COVID-19 remain unclear. The aim of this study was to describe the clinical, laboratorial and radiological characteristics of children with COVID-19.
Methods: The Medline database was searched between December 1[SUP]st[/SUP] 2019 and April 6[SUP]th[/SUP] 2020. No language restrictions were applied. Inclusion criteria were: (1) studied patients younger than 18 years old; (2) presented original data from cases of COVID-19 confirmed by reverse-transcription polymerase chain reaction; and (3) contained descriptions of clinical manifestations, laboratory tests or radiological examinations.
Results: A total of 38 studies (1,124 cases) were included. From all the cases, 1,117 had their severity classified: 14.2% were asymptomatic, 36.3% were mild, 46.0% were moderate, 2.1% were severe and 1.2% were critical. The most prevalent symptom was fever (47.5%), followed by cough (41.5%), nasal symptoms (11.2%), diarrhea (8.1%) and nausea/vomiting (7.1%). One hundred forty-five (36.9%) children were diagnosed with pneumonia and 43 (10.9%) upper airway infections were reported. Reduced lymphocyte count were reported in 12.9% of cases. Abnormalities on computed tomography were reported in 63.0% of cases. The most prevalent abnormalities reported were ground glass opacities, patchy shadows and consolidations. Only one death was reported.
Conclusions: Clinical manifestations of children with COVID-19 differ widely from adults cases. Fever and respiratory symptoms should not be considered a hallmark of COVID-19 in children. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2; children; coronavirus.
. 2020 Jun 3.
doi: 10.1002/ppul.24885. Online ahead of print.
Clinical Manifestations of Children With COVID-19: A Systematic Review
Tiago H de Souza[SUP] 1 [/SUP], Jos? A Nadal[SUP] 1 [/SUP], Roberto J N Nogueira[SUP] 1 2 [/SUP], Ricardo M Pereira[SUP] 1 [/SUP], Marcelo B Brand?o[SUP] 1 [/SUP]
Affiliations
- PMID: 32492251
- DOI: 10.1002/ppul.24885
Abstract
Background: The coronavirus disease 2019 (COVID-19) outbreak is an unprecedented global public health challenge, leading to thousands of deaths every day worldwide. Despite the epidemiological importance, clinical patterns of children with COVID-19 remain unclear. The aim of this study was to describe the clinical, laboratorial and radiological characteristics of children with COVID-19.
Methods: The Medline database was searched between December 1[SUP]st[/SUP] 2019 and April 6[SUP]th[/SUP] 2020. No language restrictions were applied. Inclusion criteria were: (1) studied patients younger than 18 years old; (2) presented original data from cases of COVID-19 confirmed by reverse-transcription polymerase chain reaction; and (3) contained descriptions of clinical manifestations, laboratory tests or radiological examinations.
Results: A total of 38 studies (1,124 cases) were included. From all the cases, 1,117 had their severity classified: 14.2% were asymptomatic, 36.3% were mild, 46.0% were moderate, 2.1% were severe and 1.2% were critical. The most prevalent symptom was fever (47.5%), followed by cough (41.5%), nasal symptoms (11.2%), diarrhea (8.1%) and nausea/vomiting (7.1%). One hundred forty-five (36.9%) children were diagnosed with pneumonia and 43 (10.9%) upper airway infections were reported. Reduced lymphocyte count were reported in 12.9% of cases. Abnormalities on computed tomography were reported in 63.0% of cases. The most prevalent abnormalities reported were ground glass opacities, patchy shadows and consolidations. Only one death was reported.
Conclusions: Clinical manifestations of children with COVID-19 differ widely from adults cases. Fever and respiratory symptoms should not be considered a hallmark of COVID-19 in children. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2; children; coronavirus.