COVID-19 under 19: A Meta-analysis

Abstract

Background: The COVID-19 pandemic has caused a global havoc with our limited understanding of the SARS-CoV-2, disease manifestations and management. Inadequacy of available data in pediatric patients coupled with evolving disease course makes it imperative to conduct a meta-analysis assessing the results of pediatric COVID-19 studies over the course of the pandemic. Methods: A random-effect meta-analysis was conducted using PRISMA guidelines. Two databases were screened for pediatric COVID-19 studies and selected articles reviewed for demographic, co-morbidities, clinical manifestations, laboratory and radiological evaluation, treatment and outcomes. Prevalence with mean and 95% confidence interval was calculated. Results: Out of 1703 articles, 37 articles comprising of 993 patients for a period of over six months and 72 variables were selected. This meta-analysis revealed that one-fourth of patients were asymptomatic (23.8%, 95% CI 17.6-31.2%) Fever (52.5%, 95% CI 45.7-59.1%) and cough (47.6%, 95% CI 41.2-54.0%) were the most common symptoms. The most frequently encountered white blood count abnormalities were neutropenia (16.6%, 95% CI 10.2-25.8%), lymphocytosis (15.3%, 95% CI 9.9-23.0%) and leukopenia (13.9%, 95% CI 10.1-18.8%). Ground glass opacities were the most common radiological finding of children with COVID-19 (35.9%, 95% CI 29.4-43%). The hospitalization rate was 95.9% (95% CI 91.9-98.0%) of which 11.2% (95% CI 4.7-24.2) were ICU admissions, and 4.2% (95% CI 2.6-6.9%) died. Conclusion: Majority of pediatric patients are asymptomatic or have mild manifestations similar to other upper respiratory viruses. Serious disease and death occurred in 15.4%. More studies are needed from a wider geographic area as the pandemic continues.

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“…Our findings of risk within populations and settings aligns with prior reports. A meta-analysis that examined pediatric inpatients estimated that 11% of children are admitted to an ICU, and 2.4% die (20); these results are similar to our estimates of 10.1 and 1.1%, respectively. Similarly, in our community analysis, 0.3% of children were admitted to an ICU and 0.02% died, closely mirroring CDC estimates of 0.7 and 0.03%, respectively (3).…”

Síndrome Inflamatória Multissistêmica e Covid-19 em crianças e adolescentes: aspectos epidemiológicos, Brasil, 2020-2021

“…Os achados deste estudo sobre baixas taxas de mortalidade por Covid-19 em crianças e adolescentes corroboram os dados da literatura 3,18, 19 . No entanto, deve-se considerar a possibilidade de sub-registro, tanto de Covid-19 como de SIM-P. Outra limitação se refere ao não acesso ao banco de dados completo do SIM-P, que ainda faz parte do sistema interno do MS, impossibilitando outras análises.…”

Persistent Neurocognitive Problems Related to COVID-19 in Children and Adolescents

“…Clinical studies have defined COVID-19 as a multisystemic infection that can affect various systems, such as cardiovascular, hematologic, renal, gastrointestinal, neurologic and hepatobiliary, and endocrinologic (3). Children and/or adolescents tend to generally have a symptomatic but mild COVID-19 course with few requiring intensive care treatment and a very low rate of mortality (1,4,5,6). Most of the children and adolescents with COVID infection in early period of the pandemic were hospitalized and a significant number of them required intensive care unit (ICU) care (6).…”

“…Children and/or adolescents tend to generally have a symptomatic but mild COVID-19 course with few requiring intensive care treatment and a very low rate of mortality (1,4,5,6). Most of the children and adolescents with COVID infection in early period of the pandemic were hospitalized and a significant number of them required intensive care unit (ICU) care (6). Despite these generally positive prognostic features of infection, multisystem inflammatory syndrome in children (MIS-C), which is a rare post-infectious hyperinflammatory disorder associated with SARS-CoV-2 and can result in severe organ dysfunction, seems to occur approximately 2-6 weeks after recovery from COVID-19 infection (7).…”