Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis
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Open Access
- 16 February 2021
- journal article
- review article
- Published by BMJ in Archives of Disease in Childhood
- Vol. 106 (5), 440-448
- https://doi.org/10.1136/archdischild-2020-321385
Abstract
Objective Compare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity. Design Systematic review and meta-analysis. Setting Between 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers conducted study screening, data abstraction and quality assessment independently and in duplicate. Observational studies describing laboratory-confirmed paediatric (0–19 years old) COVID-19 were considered for inclusion. Main outcomes and measures The pooled proportions of clinical findings, treatment and outcomes were compared according to World Bank country income level and reported disease severity. Results 129 studies were included from 31 countries comprising 10 251 children of which 57.4% were hospitalised. Mean age was 7.0 years (SD 3.6), and 27.1% had a comorbidity. Fever (63.3%) and cough (33.7%) were common. Of 3670 cases, 44.1% had radiographic abnormalities. The majority of cases recovered (88.9%); however, 96 hospitalised children died. Compared with high-income countries, in low-income and middle-income countries, a lower proportion of cases were admitted to intensive care units (ICUs) (9.9% vs 26.0%) yet pooled proportion of deaths among hospitalised children was higher (relative risk 2.14, 95% CI 1.43 to 3.20). Children with severe disease received antimicrobials, inotropes and anti-inflammatory agents more frequently than those with non-severe disease. Subgroup analyses showed that a higher proportion of children with multisystem inflammatory syndrome (MIS-C) were admitted to ICU (47.1% vs 22.9%) and a higher proportion of hospitalised children with MIS-C died (4.8% vs 3.6%) compared with the overall sample. Conclusion Paediatric COVID-19 has a favourable prognosis. Further severe disease characterisation in children is needed globally.Keywords
This publication has 141 references indexed in Scilit:
- Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in ChinaJAMA, 2020
- Clinical and CT features in pediatric patients with COVID‐19 infection: Different points from adultsPediatric Pulmonology, 2020
- Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, ChinaScience China Life Sciences, 2020
- [Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China].2020
- A Case Series of Children With 2019 Novel Coronavirus Infection: Clinical and Epidemiological FeaturesClinical Infectious Diseases, 2020
- [Analysis of CT features of 15 Children with 2019 novel coronavirus infection].2020
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 2020
- Decision coaching using a patient decision aid for youth and parents considering insulin delivery methods for type 1 diabetes: a pre/post studyBMC Pediatrics, 2020
- 0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trialCritical Care, 2020
- Systematic review on the value of end-of-treatment FDG-PET in improving overall survival of lymphoma patientsAnnals of Hematology, 2019