COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings

Mansourian, Marjan; Ghandi, Yazdan; Habibi, Danial; Mehrabi, Sarvenaz

doi:10.1016/j.arcped.2020.12.008

Cited by 68 publications

(73 citation statements)

References 37 publications

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“…In contrast, ACE1 expression was lower in children, and intestinal TMPRSS2 and NRP1 expression was similar in the two study populations. Apparently these data are in contrast with what observed in small intestinal specimens collected from patients affected by inflammatory bowel diseases where similar ACE2 and TMPRSS2 expression was reported comparing pediatric vs. adult subjects (14), or in tissue specimens collected from allergic patients (5) or with data deriving from the analysis of public gene expression datasets (32). It should be considered that these data derived mainly from subjects affected by inflammatory conditions, whereas the strength of our study is the evaluation of a well-characterized population of subjects free of any organic conditions, in which we evaluated the main mediators of SARS-CoV-2 infection.…”

Section: Discussioncontrasting

confidence: 96%

“…It has been hypothesized that differential expression of ACE2 could be responsible for the general lower severity of SARS-CoV-2 infection in children, but data are still conflicting (3)(4)(5)(6)26). In this study, we focused on the expression of the molecular mediators that regulate the SARS-CoV-2 entry into host cells: the ACE2 receptor, that acts as molecular doorway to the virus; the serine protease TMPRSS2, that is employed by SARS-CoV-2 for spike protein priming (9)(10)(11)(12)(13)(14); and the NRP1, a SARS-CoV-2 coreceptor, that enhances the ability of SARS-CoV-2 to enter and potentiates the infection in host cells (17,18).…”

Section: Discussionmentioning

confidence: 99%

“…It has been observed that gastrointestinal symptoms could be more frequent in pediatric COVID-19 cases (1,2,5,34). These clinical features could be due to a different expression of ACE2 and ACE1 in the small intestine of children.…”

Section: Discussionmentioning

confidence: 99%

“…Throughout the world, fewer cases of coronavirus disease 2019 (COVID- 19) have been reported in children than in adults. Most infected children appear to have a milder course, more frequent gastrointestinal symptoms and have better outcomes overall (1)(2)(3)(4)(5)(6)(7)(8). Defining the mechanisms underlying this disease pattern maybe relevant for the development of effective public health strategies.…”

Section: Introductionmentioning

confidence: 99%

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Age-Related Differences in the Expression of Most Relevant Mediators of SARS-CoV-2 Infection in Human Respiratory and Gastrointestinal Tract

et al. 2021

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Background: Clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection seem to differ in children compared to that in adults. It has been hypothesized that the lower clinical severity in children could be influenced by differential expression of the main host functional receptor to SARS-CoV-2, the angiotensin-converting enzyme 2 (ACE2), but data are still conflicting. To explore the origin of age-dependent clinical features of coronavirus disease 2019 (COVID-19), we comparatively evaluated the expression in children and adult subjects of the most relevant mediators of the SARS-CoV-2 infection: ACE2, angiotensin-converting enzyme 1 (ACE1), transmembrane serine protease-2 (TMPRSS2), and neuropilin-1 (NRP1), at upper respiratory tract and small intestine level.Methods: The expression of ACE2, ACE1, TMPRSS2, and NRP1 in nasal epithelium and in small intestine epithelium was investigated by quantitative real-time PCR analysis.Results: We found no differences in ACE2, ACE1, and TMPRSS2 expression in the nasal epithelium comparing children and adult subjects. In contrast, nasal epithelium NRP1 expression was lower in children compared to that in adults. Intestinal ACE2 expression was higher in children compared to that in adults, whereas intestinal ACE1 expression was higher in adults. Intestinal TMPRSS2 and NRP1 expression was similar comparing children and adult subjects.Conclusions: The lower severity of SARS-CoV-2 infection observed in children may be due to a different expression of nasal NRP1, that promotes the virus interaction with ACE2. However, the common findings of intestinal symptoms in children could be due to a higher expression of ACE2 at this level. The insights from these data will be useful in determining the treatment policies and preventive measures for COVID-19.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Age-Related Differences in the Expression of Most Relevant Mediators of SARS-CoV-2 Infection in Human Respiratory and Gastrointestinal Tract

et al. 2021

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“…In a recent meta-analysis, data were selected from 32 articles with a total sample size of 759 children [ 132 ]. Among the most common clinical manifestations was diarrhoea (19%, 95% CI 9–28%).…”

Section: Gastrointestinal Involvement In Covid-19mentioning

confidence: 99%

Twelve Months with COVID-19: What Gastroenterologists Need to Know

et al. 2021

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Corona virus disease-19 (COVID-19) is the latest global pandemic. COVID-19 is mainly transmitted through respiratory droplets and, apart from respiratory symptoms, patients often present with gastrointestinal symptoms and liver involvement. Given the high percentage of COVID-19 patients that present with gastrointestinal symptoms (GIS), in this review, we report a practical up-to-date reference for the physician in their clinical practice with patients affected by chronic gastrointestinal (GI) diseases (inflammatory bowel disease, coeliac disease, chronic liver disease) at the time of COVID-19. First, we summarised data on the origin and pathogenetic mechanism of SARS-CoV-2. Then, we performed a literature search up to December 2020 examining clinical manifestations of GI involvement. Next, we illustrated and summarised the most recent guidelines on how to adhere to GI procedures (endoscopy, liver biopsy, faecal transplantation), maintaining social distance and how to deal with immunosuppressive treatment. Finally, we focussed on some special conditions such as faecal–oral transmission and gut microbiota. The rapid accumulation of information relating to this condition makes it particularly essential to revise the literature to take account of the most recent publications for medical consultation and patient care. Supplementary Information The online version contains supplementary material available at 10.1007/s10620-021-07158-0.

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Pediatric hematology/oncology healthcare professional emotional health during COVID‐19

Schechter-Finkelstein

Plenert

Rosa

et al. 2021

Cancer Medicine

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COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings

Cited by 68 publications

References 37 publications

Age-Related Differences in the Expression of Most Relevant Mediators of SARS-CoV-2 Infection in Human Respiratory and Gastrointestinal Tract

Age-Related Differences in the Expression of Most Relevant Mediators of SARS-CoV-2 Infection in Human Respiratory and Gastrointestinal Tract

Twelve Months with COVID-19: What Gastroenterologists Need to Know

Pediatric hematology/oncology healthcare professional emotional health during COVID‐19

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