Critical cases of COVID-19 among children under 1-year account for 14%

Objectives:
What are the demographic characteristics, clinical symptoms, laboratory findings and imaging features of coronavirus disease 2019 (COVID-19) in pediatric patients?

Study design:
This review article included 48 studies with 5,829 pediatric patients (pediatrics is the branch of medicine that involves the medical care of infants, children and adolescents).

Results and conclusions:   
The investigators found children at all ages were at risk for COVID-19.

The investigators found the main illness classification ranged as: 20% [95% CI = 14% to 26%, I2 = 91.4%] asymptomatic, 33% [95% CI = 23% to 43%, I2 = 95.6%] mild and 51% [95% CI = 42% to 61%, I2 = 93.4%] moderate.

The investigators found the typical clinical manifestations were fever 51% [95% CI = 45% to 57%, I2 = 78.9%] and cough 41% [95% CI = 35% to 47%, I2 = 81.0%].

The investigators found the common laboratory findings were normal white blood cell 69% [95% CI = 64% to 75%, I2 = 58.5%], lymphopenia 16% [95% CI = 11% to 21%, I2 = 76.9%] and elevated creatine-kinase MB (CK-MB) 37% [95% CI = 25% to 48%, I2 = 59.0%].

The investigators found the frequent imaging features were normal images 41% [95% CI = 30% to 52%, I2 = 93.4%] and ground-glass opacity 36% [95% CI = 25% to 47%, I2 = 92.9%].

The investigators found among children under 1-year old, critical cases account for 14% [95% CI = 13 to 34%, I2 = 37.3%] that should be of concern.

The investigators found, in addition, vomiting occurred in 33% [95% CI = 18% to 67%, I2 = 0.0%] cases that should also need attention.

The investigators concluded pediatric patients with COVID-19 may experience milder illness with atypical clinical manifestations and rare lymphopenia. High incidence of critical illness and vomiting symptoms reward attention in children under 1-year old.

Original title:
A systematic review and meta-analysis of children with Coronavirus Disease 2019 (COVID-19) by Cui X, Zhao Z, […], Cai C.

Link:
https://pubmed.ncbi.nlm.nih.gov/32761898/

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