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. 2020 Jun 24;57(9):820–826. doi: 10.1007/s13312-020-1961-0

Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis

Jitendra Meena 1, Jaivinder Yadav 2, Lokesh Saini 2, Arushi Yadav 3, Jogender Kumar 2,✉
PMCID: PMC7498550  PMID: 32583808

Abstract

Objective

Knowledge about COVID-19 in children is limited due to the paucity of reported data. The pediatric age group comprises only less than 5% of total COVID-19 worldwide, therefore, large studies in this population are unlikely in the immediate future. Hence, we planned to synthesize the current data that will help in a better understanding of COVID-19 in children.

Evidence acquisition

Four different electronic databases (MEDLINE, EMBASE, Web of Science, and CENTRAL) were searched for articles related to COVID-19 in the pediatric population. We included studies reporting disease characteristics and outcomes of COVID-19 in patients aged less than 19 years. We performed a random-effect meta-analysis to provide pooled estimates of various disease characteristics.

Results

27 studies (4857 patients) fulfilling the eligibility criteria were included in this systematic review, from a total of 883 records. About half of the patients had each of fever and cough, 11% (6–17%) had fast breathing, and 6–13% had gastrointestinal manifestations. Most of the patients had mild to moderate disease, and only 4% had a severe or critical illness. Leukopenia was the commonest reported laboratory abnormality.

Conclusion

Even among the symptomatic COVID-19 cases, severe manifestations are seen in very few children. Though fever and respiratory symptoms are most common, many children also have gastrointestinal manifestations.

Keywords: COVID-19, Gastrointestinal symptoms, Mortality, Severity

Footnotes

Contributors

JM: conceptualized and designed the study, formulated search strategy, collected data and analyzed the data, and drafted the manuscript; JY: Acquisition and analysis of the data, and critically revised the manuscript; LS: Acquisition and analysis of the data, and critically revised the manuscript; AY: Supervised the search strategy, data retrieval, and completeness of the data. Performed hand search of the bibliographies and critically revised the manuscript; JK: Conceptualized and designed the study, formulated search strategy, collected and analyzed the data, and drafted the manuscript. All the authors approved the final version of the manuscript and will be accountable for all aspects of the work.

Funding

None

Competing interest

None stated.

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