COVID-19 in the Pediatric Population—Review and Current Evidence

Abstract

Purpose of Review Coronavirus disease 2019 (COVID-19) pandemic has major health and economic impacts. We review disease characteristics in children. Recent Findings Children comprise 1-2% of the diagnosed cases, and typically suffer mild disease. The median age of infected children is 3.3-11 years, and male/female ratio is 1.15-1.55. Common symptoms in children include upper respiratory symptoms (26-54%), cough (44-54%), fever (32-65%), and gastrointestinal (15-30%) symptoms. Substantial proportion (4-23%) are asymptomatic. Death rates are up to 0.7%. Risk factors associated with severe disease are neonatal age group, male gender, lower respiratory tract disease, and pre-existing medical conditions. Vertical transmission was reported. Multisystem inflammatory syndrome (MIS), characterized by fever, multisystem organ involvement, and laboratory markers of inflammation, causes critical illness in > 50% of cases and is increasingly reported from endemic countries. Indirect effects of the coronavirus epidemic include higher rates of psychiatric morbidities, education loss, unhealthy lifestyle changes, and increased child neglect. Vaccines are in clinical trials and immunogenicity has not yet been shown in children. Summary Overall, COVID-19 has lower incidence and causes milder disease in children compared with adult patients. MIS is a rare severe complication more common in children. More data on the efficacy and safety of antivirals in children are needed.

Critical analysis of acute kidney injury in pediatric COVID-19 patients in the intensive care unit

“…As reported recently, children only comprise about 1-2% of COVID-19 cases documented worldwide [5]. In a recent meta-analysis of 9,335 pediatric COVID-19 patients, 13.1% of the patients presented asymptomatically through contact exposure in family clusters [6]. Overall, 57.4% of patients were hospitalized and at least one underlying comorbidity was reported in 27.1% of cases [6].…”

Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents

“…One review was excluded as it was judged not to be a systematic review. 34 A review of COVID-19 in CYP with developmental disabilities was excluded as it contained no useable data. 35…”

Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden

“…Rabinowicz and others highlight some in their overview of COVID-19 in children (55). The consequences might differ from country to country depending on economic context.…”

“…Learning loss seems to be among the biggest consequences affecting children in low-income countries, but also children in medium-and high income countries. Lack of services provided by the school to children such as school meals and social support from adults other than their parents, reduced physical activity and disruptions in the social life of children and adolescents and stimulation are other possible consequences of school closures (55).…”