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.

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 the existing evidence on SARS-CoV-2 infections in pediatric age.An electronic search was conducted in PubMed database. Papers published between the 1st of January and the 7th of April, 2020 including children aged 0-18 years were selected. Fifty-two studies and two reviews were included, with a total sample size of 4.612 children (2.366 males, 51.3%, weighted mean age 7 years). Patients showed mainly mild (1285/2679, 48.5%) and moderate (1035/2679, 39.1%) signs of the infection. Less than 2% of children were admitted to the Pediatric Intensive Care Unit. The most commonly described symptoms were fever (49.2%) and cough (44.1%). Laboratory findings were often unremarkable. Children underwent a chest CT-scan in 85.7% of all cases, and 36% resulted normal. Overall, the estimated mortality was 0.07%. A higher proportion of newborns was severely ill (17%) and dyspnea was the commonest 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.

The bibliographic information of Zhang et al. 2020 (reference [61]), listed incorrectly in the original published version of the above article. Originally listed as, "61. Zhang H, Kang Z, Gong H, et al (2020) The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. bioRxiv 2020.01.30.927806.