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 2 =91.4%) asymptomatic, 33% (95% CI: 23 to 43%, I 2 =95.6%) mild and 51% (95% CI: 42 to 61%, I 2 =93.4%) moderate. The typical clinical manifestations were fever 51% (95% CI: 45 to 57%, I 2 =78.9%) and cough 41% (95% CI: 35 to 47%, I 2 =81.0%). The common laboratory findings were normal white blood cell 69% (95% CI: 64 to 75%, I 2 =58.5%), lymphopenia 16% (95% CI: 11 to 21%, I 2 =76.9%) and elevated creatine‐kinase MB (CK‐MB) 37% (95% CI: 25 to 48%, I 2 =59.0%). The frequent imaging features were normal images 41% (95% CI: 30 to 52%, I 2 =93.4%) and ground‐glass opacity 36% (95% CI: 25 to 47%, I 2 =92.9%). Among children under 1‐year old, critical cases account for 14% (95% CI: 13 to 34%, I 2 =37.3%) that should be of concern. In addition, vomiting occurred in 33% (95% CI: 18 to 67%, I 2 =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.
Single atom nonmetal 2D nanomaterials have shown considerable potential in cancer nanomedicines, owing to their intriguing properties and biocompatibility. Herein, ultrathin boron nanosheets (B NSs) are prepared through a novel top-down approach by coupling thermal oxidation etching and liquid exfoliation technologies, with controlled nanoscale thickness. Based on the PEGylated B NSs, a new photonic drug delivery platform is developed, which exhibits multiple promising features for cancer therapy and imaging, including: i) efficient NIR-light-to-heat conversion with a high photothermal conversion efficiency of 42.5%, ii) high drug-loading capacity and triggered drug release by NIR light and moderate acidic pH, iii) strong accumulation at tumor sites, iv) multimodal imaging properties (photoacoustic, photothermal, and fluorescence imaging), and v) complete tumor ablation and excellent biocompatibility. As far as it is known, this is the first report on the top-down fabrication of ultrathin 2D B NSs by the combined thermal oxidation etching and liquid exfoliation, as well as their application as a multimodal imaging-guided drug delivery platform. The newly prepared B NSs are also expected to provide a robust and useful 2D nanoplatform for various biomedical applications.
Antimonene (AM) is a recently described two-dimensional (2D) elemental layered material. In this study, a novel photonic drug-delivery platform based on 2D PEGylated AM nanosheets (NSs) is developed. The platform's multiple advantages include: i) excellent photothermal properties, ii) high drug-loading capacity, iii) spatiotemporally controlled drug release triggered by near-infrared (NIR) light and moderate acidic pH, iv) superior accumulation at tumor sites, v) deep tumor penetration by both extrinsic stimuli (i.e., NIR light) and intrinsic stimuli (i.e., pH), vi) excellent multimodal-imaging properties, and vii) significant inhibition of tumor growth with no observable side effects and potential degradability, thus addressing several key limitations of cancer nanomedicines. The intracellular fate of the prepared NSs is also revealed for the first time, providing deep insights that improve cellular-level understanding of the nano-bio interactions of AM-based NSs and other emerging 2D nanomaterials. To the best of knowledge, this is the first report on 2D AM-based photonic drug-delivery platforms, possibly marking an exciting jumping-off point for research into the application of 2D AM nanomaterials in cancer theranostics.
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