Table 1.
Studies on severity and risk factors of coronavirus disease 2019 in children (February 26 to June 10, 2020)
| First Author | Region | Study Period | Number of Children | Mean Age (% of Young Children) | Underlying Diseases Present (Diseases) | Severity | Risk Factors |
|---|---|---|---|---|---|---|---|
| Bialek et al9 | United States (33% from New York City, 23% from the rest of New York State, 15% from New Jersey, 29% from other jurisdictions) | February 12 to April 2, 2020 | 2572 | 11 (<1 y, 15%) | 23% (chronic lung disease, cardiovascular disease, immunosuppression) | 5.7%–20% hospitalized, 0.58%–2% admitted to ICU, aged <1 y: 15%–62% hospitalized, 3 deaths | Children aged <1 y, underlying condition |
| Dong et al,10 2020 | Chinese CDC, cases from Hubei province and Anhui, Henan, Hunan, Jiangxi, Shanxi, and Chongqing | January 16 to February 8, 2020 | 2135 suspected and confirmed cases | 7 (<1 y, 17.6%) | Not available | 90% had asymptomatic to moderate disease Severe or critical disease in 10.6% <1 y, 7.3% 1–5 y, 4.1% 6–10 y, 3% >16 y; 1 14-year-old boy died |
Young age |
| Lu et al,30 2020 | Wuhan Children’s Hospital, China | January 28 to February 26, 2020 | 171 | 6.7 (<1 y, 18%) | 3 patients (hydronephrosis, leukemia, intussusception) | 3 patients with invasive mechanical ventilation (all with underlying condition), 1 death | Underlying condition |
| DeBiasi et al,22 2020 | Children’s National Hospital Washington | March 15 to April 30, 2020 | 177 | 9.6 | 39% (asthma, neurologic condition, DM, obesity, cardiac problem, hematological disease, oncological condition) | 9 critically ill patients | Adolescents and young adults |
| Parri & Leng,32 2020 | Italy, 17 pediatric emergency departments, the CONFIDENCE study | March 3 to March 27, 2020 | 100 | 3.3 (40% <1 y, 14% <5 y) | 27%, cystic fibrosis; neurologic, hematological, cardiac, immunologic, oncological conditions; metabolic disease; prematurity syndrome | 1% had severe disease, 1% were in critical condition | Underlying medical condition, young age |
| Chao et al,44 2020 | Single tertiary children’s hospital, New York City | March 15 to April 13, 2020 | 67 | 13.1 | Obesity and asthma | 33 admitted to ICU | Higher levels of CRP, procalcitonin, and proBNP and platelet count |
| Whittaker et al,24 2020 | 8 hospitals in United Kingdom | March 23 to May 16, 2020 | 58 | 9 | 3 had asthma, 1 neurodisability, 1 epilepsy, 1 sickle cell disease, 1 alopecia | All had multisystem inflammatory syndrome, 50% developed shock, and 14% coronary artery aneurysm | Increased CRP and ferritin levels, older age, black or Asian race |
| Shekerdemian et al,29 2020 | 46 North American ICUs | March 14 to April 3, 2020 | 48 | 13 | 83% | All admitted to ICU, 23% had multiorgan failure, 2% needed extracorporeal membrane oxygenation, 4% died | Underlying comorbidities |
| Tagarro et al,35 2020 | 30 hospitals in Madrid, Spain | March 2 to March 16, 2020 | 41 | 1 | 27% had underlying disease | 60% hospitalized, 9.7% admitted to ICU, 9.7% needed respiratory support (1 had underlying condition) | Perhaps young age, underlying condition |
| Qiu et al,43 2020 | 3 hospitals, Zhejiang, China | January 17 to March 1, 2020 | 36 | 8.3 (<5 y, 28%) | Not available | All patients had mild or moderate type | Radiographic presentation, decreased lymphocyte counts, increased body temperature, high levels of procalcitonin, D-dimers, and creatine kinase-MB |
| Belhadjer et al,49 2020 | 14 ICUs in France and Switzerland | March 22 to April 30, 2020 | 35 | 10 | 28% had comorbidities (asthma, overweight) | Multisystem inflammatory syndrome–acute cardiac failure | Cytokine storm and macrophage activation |
| Bandi et al,23 2020 | University COVID-19 clinic, Chicago, IL | 12 March to 20 April, 2020 | 25 | 9.7 y | Not available (1 sickle cell acute pain crisis) | 20% hospitalized, 12% admitted to ICU, 1 intubated | Older age African American race |
| Zheng et al,33 2020 | 10 hospitals, Hubei, China | February 1 to February 10, 2020 | 25 | 3 (<3 y 40%) | 8% (congenital heart disease, malnutrition, suspected hereditary metabolic diseases) | Most patients had mild disease Two had critical disease (both with underlying disorder) |
Underlying disorders |
| Cheung et al,51 2020 | Columbia University Irving Medical Center/New York-Presbyterian Morgan Stanley Children’s Hospital in New York City | April 18 to May 5, 2020 | 17 | 8 | 3 mild asthma | Multisystem inflammatory syndrome | Inflammatory markers, troponin T, and NT-proBNP levels |
| Verdoni et al,48 2020 | Bergamo province, Italy | February 18 to April 20, 2020 | 10 | 7.5 | None | Multisystem inflammatory syndrome | Older age, features of macrophage activation |
| Riphagen et al,47 2020 | ICU, United Kingdom | Mid-April, 2020 | 8 | 9 | None | Multisystem inflammatory syndrome | Afro-Caribbean descent Male gender |
| Sun et al,34 2020 | ICU of Wuhan Children’s Hospital, China | January 24 to February 24, 2020 | 8 | 7 (3 children ≤1 y) | 1 acute lymphoblastic leukemia | All admitted to ICU | Increased levels of CRP, LDH, procalcitonin, abnormal liver function, cytokine storm, abnormalities on chest CT |
| Liu & Zhang,19 2020 | 3 branches of Tongji Hospital, Wuhan, China) | January 7 to January 15, 2020 | 6 | 3 (4 children ≤3 y) | None | All 4 patients ≤3 y had pneumonia, 1 admitted to ICU | Υoung age |
| Cui et al,18 2020 | Hubei Province, China | January 28, 2020 | 1 | 55 d | None | Pneumonia, myocardial injury, acute liver injury | Young age |
| Shi et al,42 2020 | Hubei Province, China | February 3, 2020 | 1 | 2 mo | None | Severe pneumonia, need for noninvasive ventilation | Young age, coinfection with RSV |
Abbreviations: CDC, Center for Disease Control and Prevention; CRP, C-reactive protein; CT, computed tomography; DM, diabetes mellitus; ICU, intensive care unit; LDH, lactate dehydrogenase; MB, myocardial band; NT-proBNP, N-terminal pro–b-type natriuretic peptide; proBNP, pro–b-type natriuretic peptide; RSV, respiratory syncytial virus.