Clinical features of infants with SARS-CoV-2 infection: a systematic review and meta-analysis

Xiao, Fei; Tang, Meiling; Yang, Kai; Zhou, Wenhao

doi:10.21037/apm-22-933

Cited by 5 publications

(6 citation statements)

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“…Within our series, fever emerged as the most common presenting symptom of COVID-19 in infants (76%), followed by upper respiratory tract (URT) symptoms (34%) and poor feeding (22%) [ 3 , 9 , 15 , 16 , 17 , 18 ]. In contrast to other reports, we observed a lower frequency of gastrointestinal symptoms.…”

Section: Discussionmentioning

confidence: 98%

“…Although it is often associated with fever or URT symptoms, poor feeding can be the only symptom observed. Thus, COVID-19 should also be considered in infants with inadequate milk intake [ 9 , 17 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…The potential risk factors for community-acquired COVID-19 in very young individuals are unclear, with speculation about whether immature immune systems pose a risk or play a protective role [ 2 , 5 , 6 , 7 , 8 ]. Several risk stratification scores for COVID-19 in young infants have been proposed but often show conflicting results, and the percentage of infants experiencing severe COVID-19 varies widely across different studies [ 1 , 3 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Course, Laboratory Findings, and Prognosis of SARS-CoV-2 Infection in Infants up to 90 Days of Age: A Single-Center Experience and a Proposal for a Management Pathway

Bellini,

Brisca,

Orfanos

et al. 2024

Healthcare

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Aim: To provide a comprehensive description of the clinical features, biochemical characteristics, and outcomes of infants up to 90 days old with COVID-19. Moreover, to assess the severity of the disease and propose an effective management pathway. Methods: Retrospective single-center study spanning three years. Patient data includes age, sex, symptoms, comorbidities, blood and urine test results, cultures, admission, length of stay, therapies, intensive care unit admission, and mortality. Results: A total of 274 patients were enrolled in the study, comprising 55% males. Among them, 60 patients (22%) were under the age of 29 days, while 214 (78%) fell within the 29 to 90 days age range. The overall incidence of SARS-CoV-2 infections was 0.28 per 10,000 Pediatric Emergency Department admissions. Blood inflammatory markers showed no significant abnormalities, and there were no recorded instances of positive blood cultures. Less than 1% of infants showed urinary tract infections with positive urine cultures, and 1.5% of patients had a concurrent RSV infection. Hospitalization rates were 83% for neonates and 67% for infants, with a median length of stay (LOS) of 48 h for both age groups. None of the patients required admission to the Pediatric or Neonatal Intensive Care Unit, and only one required High Flow Nasal Cannula (HFNC). No secondary serious bacterial infections were observed, and all hospitalized patients were discharged without short-term sequelae. No deaths were reported. Discussion and Conclusions: Infants with COVID-19 generally exhibit milder or asymptomatic forms of the disease, making home management a viable option in most cases. Blood tests, indicative of a mild inflammatory response, are recommended primarily for children showing symptoms of illness. Hospitalization precautions for infants without apparent illness or comorbidities are deemed unnecessary. Given the evolving nature of experiences with COVID-19 in infants, maintaining a high level of clinical suspicion remains imperative.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Course, Laboratory Findings, and Prognosis of SARS-CoV-2 Infection in Infants up to 90 Days of Age: A Single-Center Experience and a Proposal for a Management Pathway

Bellini,

Brisca,

Orfanos

et al. 2024

Healthcare

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“…The clinical presentation of SARS‐COV‐2 is extremely heterogeneous (Struyf et al, 2020). The severity of clinical features varies according to age and the infecting variant (Xiao et al, 2022). Based on clinical symptoms, hemodynamics, laboratory and radiographic abnormalities, and organ function, The National Institutes of Health (NIH) classify SARS‐COV‐2 into five distinct types: asymptomatic, mild, moderate, severe, and critical illness (Baj et al, 2020).…”

Section: Clinical Features Of Sars‐cov‐2mentioning

confidence: 99%

“…In infants and children, infection is associated with mild symptoms with diarrhea, fever, and cough as major clinical features (Xiao et al, 2022), (Poeta et al, 2022). In contrast, pregnant women are more likely to be affected by the virus with an increased risk of adverse maternal obstetrical complications (Diriba et al, 2020).…”

Section: Clinical Features Of Sars‐cov‐2mentioning

confidence: 99%

Exosomes in COVID‐19 infection: Focus on role in diagnosis, pathogenesis, immunity, and clinical trials

Aljuhani

Albalawi

et al. 2023

Cell Biology International

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Since the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has spread as a new strain of coronavirus disease (COVID‐19) and progressed as a global pandemic. Exosomes are membrane‐bound vesicles released from almost all cells and are crucially involved in cell–cell communication. Interestingly, COVID‐19 viral particles produce exosomes that moderate communication between infected and uninfected cells. Hence, there is growing evidence highlighting the crucial implications of exosomes in COVID‐19 infection, transmission, intercellular spread, and reinfection. On the other hand, clinical trials have demonstrated mesenchymal stem cell‐derived exosomes as a promising therapeutic strategy for severely affected COVID‐19 patients. Also, convalescent plasma‐derived exosomes have been proposed for multiple efficacies in COVID‐19 patients. Furthermore, messenger RNAs (mRNA)‐loaded exosomes were superior to mRNA‐loaded lipid nanoparticles as a delivery system. Hence, exosomes can be used to safely induce SARS‐CoV‐2 immunity via their loading with mRNAs encoding immunogenic forms of SARS‐CoV‐2 spike and nucleocapsid proteins. Moreover, exosomes can be used as a nano‐delivery system for microRNA to alleviate cytokine storm and prevent the progression of organ failure in COVID‐19 patients. The present review summarizes state of the art concerning the role of exosomes in COVID‐19 infection and accompanying organ complications as well as the potential use of exosomes in COVID‐19 diagnosis, treatment, drug delivery, and vaccination. The review also sheds the light on the common biogenic pathway between the SARS‐CoV‐2 virus and exosomes. Additionally, the latest and current clinical trials using exosomes for COVID‐19 infection are summarized.

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Evidence linking COVID-19 and the health/well-being of children and adolescents: an umbrella review

Duan,

Liu,

Wang

et al. 2024

BMC Med

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Background Experiences during childhood and adolescence have enduring impacts on physical and mental well-being, overall quality of life, and socioeconomic status throughout one’s lifetime. This underscores the importance of prioritizing the health of children and adolescents to establish an impactful healthcare system that benefits both individuals and society. It is crucial for healthcare providers and policymakers to examine the relationship between COVID-19 and the health of children and adolescents, as this understanding will guide the creation of interventions and policies for the long-term management of the virus. Methods In this umbrella review (PROSPERO ID: CRD42023401106), systematic reviews were identified from the Cochrane Database of Systematic Reviews; EMBASE (OvidSP); and MEDLINE (OvidSP) from December 2019 to February 2023. Pairwise and single-arm meta-analyses were extracted from the included systematic reviews. The methodological quality appraisal was completed using the AMSTAR-2 tool. Single-arm meta-analyses were re-presented under six domains associated with COVID-19 condition. Pairwise meta-analyses were classified into five domains according to the evidence classification criteria. Rosenberg’s FSN was calculated for both binary and continuous measures. Results We identified 1551 single-arm and 301 pairwise meta-analyses from 124 systematic reviews that met our predefined criteria for inclusion. The focus of the meta-analytical evidence was predominantly on the physical outcomes of COVID-19, encompassing both single-arm and pairwise study designs. However, the quality of evidence and methodological rigor were suboptimal. Based on the evidence gathered from single-arm meta-analyses, we constructed an illustrative representation of the disease severity, clinical manifestations, laboratory and radiological findings, treatments, and outcomes from 2020 to 2022. Additionally, we discovered 17 instances of strong or highly suggestive pairwise meta-analytical evidence concerning long-COVID, pediatric comorbidity, COVID-19 vaccines, mental health, and depression. Conclusions The findings of our study advocate for the implementation of surveillance systems to track health consequences associated with COVID-19 and the establishment of multidisciplinary collaborative rehabilitation programs for affected younger populations. In future research endeavors, it is important to prioritize the investigation of non-physical outcomes to bridge the gap between research findings and clinical application in this field.

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Clinical features of infants with SARS-CoV-2 infection: a systematic review and meta-analysis

Cited by 5 publications

References 50 publications

Clinical Course, Laboratory Findings, and Prognosis of SARS-CoV-2 Infection in Infants up to 90 Days of Age: A Single-Center Experience and a Proposal for a Management Pathway

Clinical Course, Laboratory Findings, and Prognosis of SARS-CoV-2 Infection in Infants up to 90 Days of Age: A Single-Center Experience and a Proposal for a Management Pathway

Exosomes in COVID‐19 infection: Focus on role in diagnosis, pathogenesis, immunity, and clinical trials

Evidence linking COVID-19 and the health/well-being of children and adolescents: an umbrella review

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