Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults

Abstract

Aim:The coronavirus disease 2019 pandemic has affected hundreds of thousands of people. Data on symptoms and prognosis in children are rare. Methods:A systematic literature review was carried out to identify papers on COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the MEDLINE and Embase databases between January 1 and March 18, 2020. Results:The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1%-5% of diagnosed COVID-19 cases, they often have milder disease than adults and deaths have been extremely rare.Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia.Elevated inflammatory markers were less common in children, and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID-19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances. Conclusions:The coronavirus disease 2019 has occurred in children, but they seemed to have a milder disease course and better prognosis than adults. Deaths were extremely rare.

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“…They found an elevated vulnerability to SARS-CoV-2 among infants, with a proportion of severe and critical cases of 10.6% in this age group (40 out 379 infants). However, the majority of severe and critical cases in the study were not SARS-CoV-2 confirmed, opening the debate whether other untested pathogens could have been responsible for such clinical observations [11]. In fact, SUN et al [12] showed that among eight children (age range 2 months to 15 years), who were admitted to the intensive care unit, only two (25%) were under the age of 12 months.…”

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“…The most prominent examples of this in history is smallpox, which had a minor effect on children but was catastrophic in adults [33,34]. Children recover quickly and in general, completely while it severe complications to include death result in adults [35]. Adults may be more susceptible to the virus because they are more likely to be infected with other diseases such as diabetes, high blood pressure or heart disease, which weakens their ability to ward off infection.…”