SARS-COV-2 infection in children and newborns: a systematic review

Abstract

A recent outbreak of a novel Coronavirus responsible for a Severe Acute Respiratory Syndrome (SARS-CoV-2) is spreading globally. The aim of this study was to systematically review main clinical characteristics and outcomes of SARS-CoV-2 infections in pediatric age. An electronic search was conducted in PubMed database. Papers published between 1 January and 1 May 2020 including children aged 0-18 years were selected. Sixty-two studies and three reviews were included, with a total sample size of 7480 children (2428/4660 males, 52.1%; weighted mean age 7.6 years). Patients showed mainly mild (608/1432, 42.5%) and moderate (567/1432, 39.6%) signs of the infection. About 2% of children were admitted to the pediatric intensive care unit. The most commonly described symptoms were fever (51.6%) and cough (47.3%). Laboratory findings were often unremarkable. Children underwent a chest CT scan in 73.9% of all cases, and 32.7% resulted normal. Overall, the estimated mortality was 0.08%. A higher proportion of newborns was severely ill (12%) and dyspnea was the most common reported sign (40%). Conclusion: SARS-CoV-2 affects children less severely than adults. Laboratory and radiology findings are mainly nonspecific. Larger epidemiological and clinical cohort studies are needed to better understand possible implications of COVID-19 infection in children. What is Known: • A novel Coronavirus has been recently identified as responsible for a new Severe Acute Respiratory Syndrome (SARS-CoV-2) spreading globally. • There is limited evidence on SARS-CoV2 infection in children. What is New: • Systematically reviewed available evidence showed that children with SARS-CoV-2 infection may have a less severe pattern of disease in comparison to adults. • Blood tests and radiology findings are mainly nonspecific in children but may help to identify those who are severely ill.

Clinical Spectrum of COVID-19 in a Pediatric Mexican Population

“…A meta-analysis [2] and a systematic review [3] evaluated less than ten signs and symptoms. The aim of this study was to describe a broader clinical spectrum of COVID-19 in children.…”

Exploration of Chinese Parental Awareness About COVID-19 Outbreaks

“…In this research, most participants knew that fever and cough are symptoms of COVID-19 in children, but few knew that sneezing is also a symptom. Unlikely adult patients, children with COVID- 19 have digestive symptoms (nausea, vomiting, diarrhea) [6][7][8]20]. Our research found that participants lack knowledge regarding the symptoms of COVID-19 in children ( Table 2).…”

“…However, evidence has proved children can get COVID-19 like adults, and pediatric COVID-19 cases are now gradually increasing in different countries. [6][7][8][9] The most common clinical manifestations of pediatric cases are fever, cough, or shortness of breath (over 60%) followed by headache (15% in 0-9 year old pediatric patients, 42% in 10-19 year old pediatric patients) [7][8]. According to clinical characteristics of existing pediatric cases, children with COVID-19 can be divided into ve clinical types: asymptomatic infection, mild, common, severe, and critically severe [8][9][10].…”

Aktualisierte Empfehlungen zu SARS-CoV-2/COVID-19 und Schwangerschaft, Geburt und Wochenbett

“…In den bisher publizierten Fallserien zu Neugeborenen SARS-CoV-2-positiver Mütter kommen symptomatisch erkrankte Neugeborene und einzelne Todesfälle bei Frühgeborenen SARS-CoV-2-positiver Mütter vor. Es ist jedoch nicht sicher, dass die entsprechenden Symptome durch eine Infektion mit SARS-CoV-2 verursacht wurden [30][31][32].…”