The clinical characteristics of pediatric inpatients with SARS‐CoV‐2 infection: A meta‐analysis and systematic review

Ma, Xuefeng; Liu, Shousheng; Chen, Lizhen; Zhuang, Likun; Zhang, Jie; Xin, Yongning

doi:10.1002/jmv.26208

Cited by 72 publications

(72 citation statements)

References 34 publications

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“…We included 18 reviews in our analysis. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Characteristics of the included reviews are shown in table 1; all are freely available online (see online supplemental appendix table 2). All reviews were in English.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents

Viner¹,

Ward²,

Hudson³

et al. 2020

Arch Dis Child

168

110

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ObjectiveTo undertake a systematic review of reviews of the prevalence of symptoms and signs of COVID-19 in those aged under 20 years.DesignNarrative systematic review of reviews. PubMed, medRxiv, Europe PMC and COVID-19 Living Evidence Database were searched on 9 October 2020.SettingAll settings, including hospitalised and community settings.PatientsChildren and young people (CYP) under age 20 years with laboratory-proven COVID-19.Study review, data extraction and qualityPotentially eligible articles were reviewed on title and abstract by one reviewer. Quality was assessed using the modified AMSTARS criteria and data were extracted from included studies by two reviewers.Main outcome measuresPrevalence of symptoms and signs of COVID-19.Results1325 studies were identified and 18 reviews were included. Eight were high quality, 7 medium and 3 low quality. All reviews were dominated by studies of hospitalised children. The proportion of asymptomatic CYP ranged from 14.6% to 42%. Fever and cough were the the most common symptoms; proportions with fever ranged from 46% to 64.2% and with cough from 32% to 55.9%. All other symptoms or signs including rhinorrhoea, sore throat, headache, fatigue/myalgia and gastrointestinal symptoms including diarrhoea and vomiting were infrequent, occurring in less than 10%–20%.ConclusionsFever and cough are the most common symptoms in CYP with COVID-19, with other symptoms infrequent. Further research on symptoms in community samples are needed to inform pragmatic identification and testing programmes for CYP.

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Section: Resultsmentioning

confidence: 99%

Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents

Viner¹,

Ward²,

Hudson³

et al. 2020

Arch Dis Child

168

110

View full text Add to dashboard Cite

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“…The majority of patients had asymptomatic presentation (11/14; 79%) and those with symptoms (3/14; 21%) only showed mild upper respiratory tract infection. It had been shown that asymptomatic SARS-CoV-2 infection is variable and was 17% among household contacts [ 20 ], 17.4% among children in a meta-analysis [ 21 ], and 10% of 100 SARS-COV-2 patients in Taiwan [ 22 ]. In one study, asymptomatic patients were more likely to be present among those <45 years of age but could occur at any age [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of COVID-19 among returning travelers in quarantine facilities: A longitudinal study and lessons learned

Al‐Tawfiq

Sattar

Al-Khadra

et al. 2020

Travel Medicine and Infectious Disease

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Introduction The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) had resulted in an unpresented global pandemic. In the initial events, the Kingdom of Saudi Arabia implemented mandatory quarantine of returning travelers in order to contain COVID-19 cases. Materials and methods This is a longitudinal study of the arriving travelers to Quarantine facilities and the prevalence of positive SARS-CoV-2 as detected by RT-PCR. Results During the study period, there was a total of 1928 returning travelers with 1273 (66%) males. The age range was 28 days–69 years. Of all the travelers, 23 (1.2%) tested positive for SARS-CoV-2. Of the first swab, 14/1928 (0.7%) tested positive. The positivity rate was 0.63% and 0.92% among males and females, respectively (P = 0.57). The second swab was positive in 9 (0.5%) of the other 1914 who were initially negative with a positivity rate of 0.39% and 0.62% among males and females, respectively (P = 0.49). There was no statistical difference in the positivity rates between first and second swab (P = 0.4). Of all travelers, 40 (n = 26, 1.3%) were admitted from the quarantine facility to the hospital due to COVID-19 related positive results or development of symptoms such as fever, cough, and respiratory symptoms; and 14 (0.7%) were admitted due to non-COVID-19 related illness. Conclusion This study showed the efforts put for facility quarantine and that such activity yielded a lower incidence of positive cases. There was a need to have a backup healthcare facility to accommodate those developing a medical need for evaluation and admission for non-COVID-19 related illnesses.

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“…For this reason, most of the guidelines published so far are more appropriate for adults than for children. Several systematic reviews with simple meta-analysis have been reported, but these have mainly focused on the clinical characteristics of pediatric COVID-19 (5)(6)(7), and data on the transmissibility, rate of viral coinfections, and treatments of pediatric COVID-19 are still lacking. Asymptomatic transmission is the Achilles' heel of COVID-19 pandemic control, as reported by Gandhi et al (8), but the number of asymptomatic infections in children is unknown.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

et al. 2020

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Given the relatively low rate and limited publicly available data regarding children with SARS-CoV-2 infection, this knowledge gap should be addressed with urgency. This systematic review with meta-analysis aimed to evaluate the epidemiological spectrum and clinical characteristics of children infected with SARS-CoV-2. Relevant international and Chinese public databases were systematically searched to identify all case studies from January 1, 2020 to May 7, 2020. This study consisted of 96 studies involving 7004 cases. The mean age of pediatric cases was 6.48 years (95% CI 52.0-77.5), 90% had household contact, and 66% presented with mild to moderate clinical syndromes. The main symptoms were fever (47%, 95% CI 41-53%) and cough (42%, 95% CI 36-48%). About 23% of children were asymptomatic, 27% had comorbidity, and 29% had a co-infection. The pooled mean incubation period was 9.57 days (95% CI 7.70-11.44). The shedding of SARS-CoV-2 in the upper respiratory tract lasted 11.43 days, and 75% of patients had virus particles in their stool. A total of 34% of the children had neutropenia and 26% had lymphocytosis. Interferon-alpha (81%) was the most commonly used antiviral drug in the children. The discharge and death rates were 79 and 1%. In conclusion, the transmissibility of pediatric COVID-19 should be not ignored because of the relatively long incubation period, shedding duration, and mild clinical syndromes.

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The clinical characteristics of pediatric inpatients with SARS‐CoV‐2 infection: A meta‐analysis and systematic review

Cited by 72 publications

References 34 publications

Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents

Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents

Incidence of COVID-19 among returning travelers in quarantine facilities: A longitudinal study and lessons learned

Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

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