SARS-CoV-2 (COVID-19): What Do We Know About Children? A Systematic Review

Abstract

BACKGROUND Few paediatric cases of COVID-19 have been reported and we know little about the epidemiology in children, though more is known about other coronaviruses. We aimed to understand the infection rate, clinical presentation, clinical outcomes and transmission dynamics for SARS-CoV-2, in order to inform clinical and public health measures. METHODS We undertook a rapid systematic review and narrative synthesis of all literature relating to SARS-CoV-2 in paediatric populations. The search terms also included SARS-CoV and MERS-CoV. We searched three databases and the COVID-19 resource centres of eleven major journals and publishers. English abstracts of Chinese language papers were included. Data were extracted and narrative syntheses conducted. RESULTS 24 studies relating to COVID-19 were included in the review. Children appear to be less affected by COVID-19 than adults by observed rate of cases in large epidemiological studies. Limited data on attack rate indicate that children are just as susceptible to infection. Data on clinical outcomes are scarce but include several reports of asymptomatic infection and a milder course of disease in young children, though radiological abnormalities are noted. Severe cases are not reported in detail and there are little data relating to transmission. CONCLUSIONS Children appear to have a low observed case rate of COVID-19 but may have similar rates to adults of infection with SARS-CoV-2. This discrepancy may be because children are asymptomatic or too mildly infected to draw medical attention, be tested and counted in observed cases of COVID-19.

Case of multisystem inflammatory syndrome in children presenting as fever and abdominal pain

“…1 2 Paediatric patients are believed to exhibit a milder course than adults. [3][4][5][6] While the complications of COVID-19 in adult patients are better recognised, the morbidities in paediatric patients have only recently become apparent. 5 6 A new syndrome affecting paediatric patients with COVID-19, multisystem inflammatory syndrome in children (MIS-C), has been defined by the Centers for Disease Control and Prevention (CDC) and the WHO.…”

Mütter-Screening in einem COVID-19-Niedrig-Pandemiegebiet: Bestimmung SARS-CoV-2-spezifischer Antikörper bei 401 Rostocker Müttern mittels ELISA und Immunfluoreszenz-Bestätigungstest

“…In Mecklenburg-Vorpommern wurden auch deutlich weniger Infektionen bei Kindern als bei Erwachsenen gemeldet. Diese niedrige Infektionsrate bei Kindern deckt sich mit den Aussagen anderer Studien [15,16]. Die Daten einer weiteren Studie aus Shanghai und Wuhan legen nahe, dass die Empfänglichkeit für die Infektion mit SARS-CoV-2 bei Kindern unter 15 Jahren nur etwa ein Drittel so hoch ist wie bei 15-bis 65-Jährigen, und dass die Schließung von Schulen und Kindergärten trotzdem wahrscheinlich einen signifikanten Beitrag zur Verlangsamung der Infektionsausbreitung geleistet hat [18].…”

<p>Clinical Profile of Covid-19 in Children, Review of Existing Literatures</p>

“…Most infected children have had mild symptoms with no fever or pneumonia, and have an excellent prognosis. 63 However; few of them suffer from life-threatening complications. Few studies have tried to show that children with underlying serious conditions appear to be at greatest risk.…”