A comparative‐descriptive analysis of clinical characteristics in 2019‐coronavirus‐infected children and adults

Han, Yanan; Feng, Zhanwei; Sun, Lei; Ren, Xiaoxia; Wang, Hua; Xue, Yong‐ming; Wang, Yi; Fang, Ying

doi:10.1002/jmv.25835

Cited by 78 publications

(86 citation statements)

References 15 publications

(11 reference statements)

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“…Ninety‐two articles (of which four included pregnant patients) reported adult patients infected with SARS‐CoV‐2. Eleven articles included paediatric population, and four articles reported both adults and children infected with SARS‐CoV‐2 2,7,14‐118 . (Tables S1, S2 and S3) A total of 20 874 patients were included, of which 38 were pregnant patients, 395 were paediatric patients and the rest were adult patients.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Kulkarni

Kumar

Tevethia

et al. 2020

Aliment Pharmacol Ther

208

287

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Summary Background The incidence of elevated liver chemistries and the presence of pre‐existing chronic liver disease (CLD) have been variably reported in COVID‐19. Aims To assess the prevalence of CLD, the incidence of elevated liver chemistries and the outcomes of patients with and without underlying CLD/elevated liver chemistries in COVID‐19. Methods A comprehensive search of electronic databases from 1 December 2019 to 24 April 2020 was done. We included studies reporting underlying CLD or elevated liver chemistries and patient outcomes in COVID‐19. Results 107 articles (n = 20 874 patients) were included for the systematic review. The pooled prevalence of underlying CLD was 3.6% (95% CI, 2.5‐5.1) among the 15 407 COVID‐19 patients. The pooled incidence of elevated liver chemistries in COVID‐19 was 23.1% (19.3‐27.3) at initial presentation. Additionally, 24.4% (13.5‐40) developed elevated liver chemistries during the illness. The pooled incidence of drug‐induced liver injury was 25.4% (14.2‐41.4). The pooled prevalence of CLD among 1587 severely infected patients was 3.9% (3%‐5.2%). The odds of developing severe COVID‐19 in CLD patients was 0.81 (0.31‐2.09; P = 0.67) compared to non‐CLD patients. COVID‐19 patients with elevated liver chemistries had increased risk of mortality (OR‐3.46 [2.42‐4.95, P < 0.001]) and severe disease (OR‐2.87 [95% CI, 2.29‐3.6, P < 0.001]) compared to patients without elevated liver chemistries. Conclusions Elevated liver chemistries are common at presentation and during COVID‐19. The severity of elevated liver chemistries correlates with the outcome of COVID‐19. The presence of CLD does not alter the outcome of COVID‐19. Further studies are needed to analyse the outcomes of compensated and decompensated liver disease.

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Section: Resultsmentioning

confidence: 99%

“…Seventy‐six articles, including 13 141 patients, described elevated liver chemistries at initial presentation 7,14‐34,46,47,49‐52,54‐75,77‐84,86,88‐93,102‐112 . The incidence of elevated liver chemistries varied from 1.1% to 68% in COVID‐19 patients 84,89 .…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Kulkarni

Kumar

Tevethia

et al. 2020

Aliment Pharmacol Ther

208

287

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“…After review of the titles and abstracts, 63 studies were considered to meet the criteria for full-text scanning. After removal of reviews, duplicate articles with smaller sample size, and studies which did not report liver biochemical parameters, 23 studies met the inclusion criteria [18] , [19] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] . Additionally, two studies were enrolled after review of the reference lists of all included studies and major review and meta-analyses [44] , [45] .…”

Section: Resultsmentioning

confidence: 99%

“…All these studies were published in 2020 and could be divided into non-survivors group and survivors group. Among them, 23 studies were from China [18] , [19] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [45] , one from the United States [35] and one from Spain [44] . Among the 23 studies from China, 20 studies were written in English and three in Chinese [18] , [28] , [42] .…”

Section: Resultsmentioning

confidence: 99%

Prognostic value of liver biochemical parameters for COVID-19 mortality

Lin

Chen²,

Wang

et al. 2021

Annals of Hepatology

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Introduction Coronavirus Disease 2019 (COVID-19) has brought great challenges to global public health. However, a comprehensive analysis of the relationship between liver biochemical parameters and COVID-19 mortality is quite limited. Methods We searched the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, Scopus, Wanfang and China National Knowledge Infrastructure database until May 5, 2020. STATA software was used for the statistical analyses. Results A total of 25 studies involving 5971 COVID-19 patients were included in our analysis. Compared with non-survivors, survivors had lower levels of aspartate aminotransferase (AST) (weighted mean difference [WMD] = -16.71 U/L, 95%CI = [-21.03, -12.40], P < 0.001), alanine transaminase (ALT) (WMD = -5.20U/L, 95%CI = [-8.00, -2.41], P < 0.001), total bilirubin (TBIL) (WMD = 4.40μmol/L, 95%CI = [-5.11, -3.70], P < 0.001) and lactic dehydrogenase (LDH) (WMD = -252.44U/L, 95%CI = [-289.57, -215.30], P < 0.001), and higher albumin (ALB) level (WMD = 4.47 g/L, 95%CI = [3.47, 5.47], P < 0.001). Besides, survivors had lower proportions of these abnormally increased parameters (AST: OR = 0.25, 95%CI = [0.15, 0.41], P < 0.001; ALT: OR = 0.49, 95%CI = [0.37, 0.64], P < 0.001; TBIL: (OR = 0.20, 95%CI = [0.12, 0.34], P < 0.001; LDH, OR = 0.09, 95%CI = [0.06, 0.14], P < 0.001), and lower proportion of abnormally decreased ALB (OR = 0.16, 95%CI = [0.07, 0.38], P < 0.001). Meta-analysis based on standard mean difference and sensitivity analysis did not change the conclusions. Egger test did not detect the presence of publication bias. Conclusions Liver biochemical parameters were strongly correlated with COVID-19 mortality. Measurement of these liver biochemical parameters might assist clinicians to evaluate the prognosis of COVID-19.

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“…Children 's Hospital from 2020/1/7 to 2020/1/15, among whom, four had vomiting (66.7%). Han YN in Xi'an, China 15 included seven patients in their study, four of whom (57.1%) had diarrhea or vomiting; however, the number of cases was too small to be conclusive. Other reports come from six provinces in north China (Shaanxi, Gansu, Ningxia, Hebei, Henan, and Shandong).…”

Section: Gastrointestinal Symptoms In Covid-19mentioning

confidence: 99%

Gastrointestinal symptoms and fecal nucleic acid testing of children with coronavirus disease 2019: a systematic review and meta-analysis

Wang

Cui

Tang

2020

Preprint

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Objective: To understand the clinical manifestations and incidence of gastrointestinal symptoms of Coronavirus disease (COVID-19) in children and discuss the importance of fecal nucleic acid testing.Methods: Retrospective analysis of studies of gastrointestinal symptoms and fecal nucleic acid detection in pediatric COVID-19 since the outbreak of COVID-19, as well as prospective clinical studies and case reports to understand the clinical characteristics of gastrointestinal symptoms and feces in children. Nucleic acid detection results were also analyzed.Results: 1. The clinical manifestations of gastrointestinal symptoms in children with COVID-19 are mostly vomiting and diarrhea, with a total incidence rate of 21.1% (95%Cl=0.14-0.28).2.When analyzing by country (studies from China versus studies from other countries), the pooled prevalence of gastrointestinal symptoms in studies from countries other than China was much lower at 18.2% (95% CI0.05 to 0.31). This is in comparison to studies from China where the prevalence was higher: 23.3% (95% CI 0.153 to 0.310) .3.In Wuhan patients, the pooled prevalence was much higher at 41.2% (95 % CI 0.147 to 0.678) as compared to areas outside Wuhan，China：15.1%(95 % CI 0.075 to 0.227).4.Fecal nucleic acid detection is as accurate as respiratory specimen nucleic acid detection. The positive rate of fecal nucleic acid testing in COVID-19 patients was 92.5% (25/27). In patients where nucleic acid tests of respiratory tract specimens produced negative results, a positive fecal nucleic acid test result was present in 83.3% (20/24); one week after the respiratory tract specimen was nucleic acid-negative, 54.1% (13/24) were fecal nucleic acid-positive; two weeks after the respiratory tract nucleic acid negative test, 37.5% (9/24) were fecal nucleic acid-positive. The longest interval between a negative respiratory system result and positive fecal specimen result exceeded 19 days.Conclusions and Relevance: Gastrointestinal symptoms in pediatric COVID-19 are relatively common. Attention should be paid to the detection of fecal nucleic acids in children. Fecal nucleic acid-negative status should be considered as one of the desegregation standards.

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A comparative‐descriptive analysis of clinical characteristics in 2019‐coronavirus‐infected children and adults

Cited by 78 publications

References 15 publications

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Prognostic value of liver biochemical parameters for COVID-19 mortality

Gastrointestinal symptoms and fecal nucleic acid testing of children with coronavirus disease 2019: a systematic review and meta-analysis

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