Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: A systematic review and meta-analysis

Badal, Sujan; Bajgain, Kalpana Thapa; Badal, Sujeena; Thapa, Rama; Bajgain, Bishnu Bahadur; Santana, Maria

doi:10.1016/j.jcv.2020.104715

Cited by 126 publications

(134 citation statements)

References 43 publications

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“…A metanalysis including 1,810 pediatric patients all with PCR tested positive for COVID-19 demonstrates a prevalence of GI symptoms of 6% with higher prevalence of fever (55%), cough (45%), and dyspnea (19%) ( 47 ).…”

Section: Sars-cov-2 and Gastrointestinal Tractmentioning

confidence: 99%

SARS-CoV-2 and the Gastrointestinal Tract in Children

et al. 2021

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Coronavirus disease 2019 (COVID-19), caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is predominantly a respiratory disease. However, its significant impact on the gastrointestinal (GI) system is now well-known. SARS-CoV-2 enters cells via the angiotensin-converting enzyme-2 (ACE-2) receptor, which is abundantly expressed on lung cells, but also on enterocytes. Several etiopathogenetic mechanisms have been postulated to explain the GI involvement in COVID-19, including loss in intestinal absorption, microscopic mucosal inflammation and impaired ACE-2 function, which plays a significant role in maintaining gut homeostasis. In children the GI manifestations include anorexia, nausea, vomiting, diarrhea and abdominal pain, which may represent the earliest presenting symptoms of the disease. However, although rare, a significant GI mucosal inflammation, such as terminal ileitis mimicking an atypical appendicitis, and other GI manifestations have been reported. COVID-19 pandemic has posed a significant challenge in healthcare provision in term of ability in providing safe diagnostic procedures, face-to-face consultations, and offering comprehensive care. For instance, changes in health services have raised the risk of empirical or sub-optimal management of chronic GI disorders such as inflammatory bowel disease (IBD) due to delayed endoscopic and clinical assessment. This review will discuss the acute GI involvement in COVID-19 in children and reflect on challenges and major changes observed in clinical practice during COVID-19 pandemic by sharing both the published literature and personal experience. We also suggest potential strategies for providing optimal gastroenterology care during this unprecedented era.

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Section: Sars-cov-2 and Gastrointestinal Tractmentioning

confidence: 99%

SARS-CoV-2 and the Gastrointestinal Tract in Children

et al. 2021

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“…In a review that included 655 pediatric patients, 17.1% showed low leucocyte levels, and 13.3% had lymphopenia or neutropenia (18). In other publications that summarize various studies, high levels of ferritin in 26% of children (12), elevation of C-reactive protein in 19%, and procalcitonin in 25-31% have been reported (5,12). All these alterations present possibly in the context of greater severity secondary to a more inflammatory response.…”

Section: Laboratory Datamentioning

confidence: 99%

“…COVID-19 occurs in children of all ages ( 10 ); however, the pediatric disease represents <5% of total cases ( 11 ). In this population, the infection predominates in school children and adolescents ( 12 ); the Center of Disease Control and Prevention (CDC) reports 386,329 cases in the United States ( 13 ). The percentage of cases is slightly higher in females compared with males (50.5 vs. 49.5%), and the rate of mortality is extremely low in both populations (<0.1%; 62 deaths) with a greater percentage of deaths in males (52.5%) ( 14 ).…”

Section: Epidemiological Issuesmentioning

confidence: 99%

“…The demonstration of SARS-CoV-2 through the reverse transcription polymerase chain reaction (RT-PCR) test confirms diagnosis ( 15 , 19 , 28 , 47 ); it is particularly useful in children given their heterogeneity in presentation of COVID-19 ( 12 ). In some cases, it is possible to find patients with a high index of suspicion for this viral infection with suggestive symptoms and/or a history of exposure and a negative test result in whom it can be necessary to repeat ( 48 ).…”

Section: Diagnosismentioning

confidence: 99%

“…The recovery is faster probably due to lower affectation and a better immune response ( 60 ), but complications in the presence of co-morbidities are more likely ( 10 , 61 , 62 ). Although mortality in cases requiring pediatric intensive care units (PICU) is low ( 12 , 63 ), an increase is being observed.…”

Section: Clinical Presentationmentioning

confidence: 99%

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COVID-19 in Children: Respiratory Involvement and Some Differences With the Adults

Hernández

Orozco

2021

Front. Pediatr.

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The coronavirus disease 2019 (COVID-19) represents a health problem with multidimensional impacts and heterogeneous respiratory involvement in children, probably due to the interaction between different and complex mechanisms that could explain its variable degrees of severity. Although the majority of reports reveal that children develop less severe cases, the number of patients is increasing with more morbidity. Most serious respiratory manifestations are acute respiratory distress syndrome (ARDS) and pneumonia. By understanding the key aspects that can be used to differentiate between pediatric and adult respiratory compromise by COVID-19, we can improve our knowledge, and thus decrease the negative impact of the disease in the pediatric population. In this mini review, we summarize some of the mechanisms and findings that distinguish between adult and pediatric COVID-19 and respiratory involvement, taking into account some issues related to the physiopathology, diagnosis, clinical and paraclinical presentation, severity, treatment, and control of the disease.

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Hematological changes associated with COVID‐19 infection

Al-Saadi

Abdulnabi

2021

Clinical Laboratory Analysis

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Background The unresolved COVID‐19 pandemic considerably impacts the health services in Iraq and worldwide. Consecutive waves of mutated virus increased virus spread and further constrained health systems. Although molecular identification of the virus by polymerase chain reaction is the only recommended method in diagnosing COVID‐19 infection, radiological, biochemical, and hematological studies are substantially important in risk stratification, patient follow‐up, and outcome prediction. Aim This narrative review summarized the hematological changes including the blood indices, coagulative indicators, and other associated biochemical laboratory markers in different stages of COVID‐19 infection, highlighting the diagnostic and prognostic significance. Methods Literature search was conducted for multiple combinations of different hematological tests and manifestations with novel COVID‐19 using the following key words: “hematological,” “complete blood count,” “lymphopenia,” “blood indices,” “markers” "platelet" OR "thrombocytopenia" AND "COVID‐19," "coronavirus2019," "2019‐nCoV," OR "SARS‐CoV‐2." Articles written in the English language and conducted on human samples between December 2019 and January 2021 were included. Results Hematological changes are not reported in asymptomatic or presymptomatic COVID‐19 patients. In nonsevere cases, hematological changes are subtle, included mainly lymphocytopenia (80.4%). In severe, critically ill patients and those with cytokine storm, neutrophilia, lymphocytopenia, elevated D‐dimer, prolonged PT, and reduced fibrinogen are predictors of disease progression and adverse outcome. Conclusion Monitoring hematological changes in patients with COVID‐19 can predict patients needing additional care and stratify the risk for severe course of the disease. More studies are required in Iraq to reflect the hematological changes in COVID‐19 as compared to global data.

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Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: A systematic review and meta-analysis

Cited by 126 publications

References 43 publications

SARS-CoV-2 and the Gastrointestinal Tract in Children

SARS-CoV-2 and the Gastrointestinal Tract in Children

COVID-19 in Children: Respiratory Involvement and Some Differences With the Adults

Hematological changes associated with COVID‐19 infection

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