Table 2.
Characteristics | # Studies | Sample size | Association measure | Effect size | Heterogeneity | Publication bias | |||
---|---|---|---|---|---|---|---|---|---|
Estimate | 95% CI | P value | I2 | P value | P value | ||||
Demographic data | |||||||||
Age, y | 15 | 318 | M | 9.10 | 8.494, 9.714 | < 0.001 | 0.0% | 1.00 | 0.715 |
Sex: (girls) | 15 | 318 | P | 49.50 | 43.0, 56.1 | < 0.001 | 27.89% | 0.15 | 0.775 |
Sex: (boys) | 15 | 318 | P | 50.50 | 43.9, 57.0 | < 0.001 | 27.89% | 0.15 | 0.774 |
BMI, kg/m2 | 5 | 95 | M | 19.34 | 17.86, 20.82 | < 0.001 | 19.0% | 0.29 | 0.063 |
Race: (Black) | 8 | 229 | P | 36.80 | 26.3, 47.4 | < 0.001 | 65.77% | 0.005 | 0.501 |
Race: (Asian) | 7 | 185 | P | 13.60 | 4.70, 22.6 | 0.003 | 74.51% | < 0.001 | 0.032 |
Race: (White) | 8 | 229 | P | 16.40 | 10.7, 22.1 | < 0.001 | 27.76% | 0.20 | 0.285 |
SARS-CoV-2 screening | |||||||||
Nasopharyngeal RT-PCR | 7 | 138 | P | 46.50 | 12.9, 80.1 | 0.007 | 96.25% | < 0.001 | 0.277 |
Anti-SARS-CoV-2 IgG | 8 | 167 | P | 69.60 | 48.9, 90.2 | < 0.001 | 91.31% | < 0.001 | 0.471 |
C. Kawasaki dis criteria | |||||||||
Fever | 9 | 177 | P | 82.40 | 69.8, 95.1 | < 0.001 | 94.23% | < 0.001 | 0.018 |
Lips/oral cavity changes | 6 | 124 | P | 58.10 | 38.6, 77.6 | < 0.001 | 82.64% | < 0.001 | 0.585 |
Conjunctival injection | 10 | 227 | P | 56.00 | 40.0, 71.9 | < 0.001 | 85.56% | < 0.001 | 0.227 |
Rash | 11 | 235 | P | 63.70 | 53.8, 73.5 | < 0.001 | 59.62% | 0.006 | 0.267 |
Changes to extremities | 4 | 101 | P | 40.70 | 12.9, 68.5 | 0.004 | 86.67% | < 0.001 | 0.537 |
Cervical lymphadenopathy | 6 | 136 | P | 28.50 | 13.9, 43.1 | < 0.001 | 73.13% | 0.002 | 0.918 |
Presentations | |||||||||
Gastrointestinal | 14 | 303 | P | 79.40 | 68.1, 90.7 | < 0.001 | 92.48% | < 0.001 | 0.012 |
Neurocognitive | 11 | 271 | P | 31.80 | 21.9, 41.8 | < 0.001 | 70.30% | < 0.001 | 0.757 |
Respiratory | 8 | 232 | P | 29.60 | 19.6, 39.6 | < 0.001 | 66.65% | 0.004 | 0.948 |
E. Comorbidities | |||||||||
Asthma | 3 | 82 | P | 14.60 | 6.9, 22.2 | < 0.001 | 0.0% | 0.96 | NA |
Obesity | 4 | 126 | P | 26.00 | 7.1, 44.9 | 0.007 | 85.99% | < 0.001 | 0.092 |
Investigations | |||||||||
Abnormal ECG | 6 | 89 | P | 55.30 | 45.1, 65.6 | < 0.001 | 0.0% | 0.88 | 0.365 |
Abnormal Chest X-ray | 3 | 70 | P | 45.50 | 24.9, 66.0 | < 0.001 | 68.97% | 0.040 | 0.187 |
Laboratory tests | |||||||||
WBCs, × 109/L | 8 | 228 | M | 13.20 | 10.82, 15.59 | < 0.001 | 84.99% | < 0.001 | 0.198 |
Lymphocytes, × 109/L | 9 | 208 | M | 0.93 | 0.737, 1.125 | < 0.001 | 70.06% | < 0.001 | 0.067 |
Neutrophils, × 109/L | 4 | 115 | M | 12.67 | 8.56, 16.76 | < 0.001 | 87.44% | < 0.001 | 0.471 |
Platelets, × 109/L | 9 | 239 | M | 180.01 | 154.4, 205.6 | < 0.001 | 65.77% | 0.003 | 0.027 |
Hemoglobin, g/dL | 7 | 106 | M | 10.4 | 9.55, 11.39 | < 0.001 | 80.20% | < 0.001 | 0.703 |
Troponin, ng/L | 12 | 241 | M | 110.71 | 59.08, 162.3 | < 0.001 | 72.76% | < 0.001 | 0.426 |
NT-proBNP, pg/mL | 12 | 241 | M | 5648.78 | 3823, 7474 | < 0.001 | 95.45% | < 0.001 | 0.374 |
LDH, U/L | 5 | 158 | M | 637.21 | 358.7, 915.7 | < 0.001 | 96.02% | < 0.001 | 0.205 |
ALT, U/L | 8 | 232 | M | 46.86 | 39.1, 54.6 | < 0.001 | 36.71% | 0.13 | 0.009 |
AST, U/L | 4 | 127 | M | 52.89 | 45.9, 59.8 | < 0.001 | 0.0% | 0.56 | 0.299 |
Albumin, g/L | 9 | 239 | M | 27.15 | 23.5, 30.7 | < 0.001 | 95.65% | < 0.001 | 0.324 |
Creatinine, μmol/L | 6 | 151 | M | 74.93 | 59.4, 90.4 | < 0.001 | 38.58% | 0.14 | 0.039 |
Sodium, mmol/L | 8 | 150 | M | 131.70 | 129.3, 134.1 | < 0.001 | 88.98% | < 0.001 | 0.094 |
CRP, mg/L | 12 | 262 | M | 215.58 | 192.5, 238.7 | < 0.001 | 55.15% | 0.011 | 0.652 |
ESR, mm/h | 4 | 102 | M | 64.64 | 54.28, 74.99 | < 0.001 | 38.30% | 0.18 | 0.335 |
Ferritin, ng/mL | 9 | 194 | M | 763.24 | 658.8, 867.6 | < 0.001 | 16.93% | 0.29 | 0.018 |
Fibrinogen, g/L | 4 | 144 | M | 6.24 | 4.68, 7.80 | < 0.001 | 96.03% | < 0.001 | 0.166 |
Procalcitonin, ng/mL | 6 | 117 | M | 19.24 | 8.67, 29.80 | < 0.001 | 73.16% | 0.002 | 0.002 |
Interleukin-6, pg/mL | 4 | 115 | M | 189.67 | 145.4, 233.8 | < 0.001 | 0.0% | 0.512 | 0.122 |
D-dimer, μg/mL | 8 | 191 | M | 3.79 | 2.57, 5.02 | < 0.001 | 89.25% | < 0.001 | 0.025 |
Prothrombin time, sec | 3 | 56 | M | 4.09 | 2.92, 5.27 | < 0.001 | 99.07% | < 0.001 | 0.318 |
Complications | |||||||||
Shock | 5 | 158 | P | 68.10 | 51.9, 84.3 | < 0.001 | 80.67% | < 0.001 | 0.085 |
Hypotension | 5 | 75 | P | 77.00 | 56.9, 97.0 | < 0.001 | 82.18% | < 0.001 | 0.147 |
Acute kidney injury | 4 | 141 | P | 41.10 | 15.0, 67.1 | 0.002 | 91.83% | < 0.001 | 0.665 |
PICU admission | 10 | 173 | P | 73.70 | 60.3, 87.1 | < 0.001 | 86.52% | < 0.001 | 0.137 |
Mechanical ventilation | 9 | 198 | P | 37.90 | 28.3, 47.6 | < 0.001 | 46.46% | 0.060 | 0.887 |
Intubation | 2 | 102 | P | 13.2 | 0.5, 82.1 | 0.27 | 97.16% | < 0.001 | NA |
Length of stay, days | 5 | 112 | M | 6.77 | 4.93, 8.60 | < 0.001 | 86.81% | < 0.001 | 0.392 |
Medications | |||||||||
Epinephrine | 3 | 61 | P | 40.20 | 7.2, 73.2 | 0.017 | 86.03% | < 0.001 | 0.942 |
Norepinephrine | 3 | 61 | P | 45.10 | 9.0, 81.2 | 0.014 | 91.26% | < 0.001 | 0.470 |
Milrinone vasodilator | 3 | 61 | P | 42.90 | 2.7, 83.0 | 0.036 | 91.94% | < 0.001 | 0.954 |
Intravenous Ig | 12 | 258 | P | 87.70 | 80.8, 94.7 | < 0.001 | 77.75% | < 0.001 | 0.001 |
Steroids | 7 | 188 | P | 56.90 | 33.6, 80.2 | < 0.001 | 94.68% | < 0.001 | 0.878 |
Anakinra (anti-IL1) | 5 | 184 | P | 9.40 | 4.6, 14.2 | < 0.001 | 20.31% | 0.28 | 0.155 |
Hydroxychloroquine | 2 | 33 | P | 13.5 | 5.1, 31.0 | 0.001 | 5.99% | 0.30 | NA |
Infliximab (anti-TNF) | 2 | 91 | P | 8.5 | 2.0, 29.6 | 0.002 | 74.61% | 0.047 | NA |
Anticoagulants | 8 | 170 | P | 67.00 | 47.6, 86.3 | < 0.001 | 94.12% | < 0.001 | 0.447 |
The random-effects model was applied. Association measure: pooled mean (M) was estimated for quantitative variables and untransformed proportions (P) were calculated for categorical events; I2: the ratio of true heterogeneity to total observed variation; publication bias: assessed by Egger’s test. CI confidence interval; BMI body mass index; Gastrointestinal symptoms included vomiting, diarrhea, and abdominal pain; Neurocognitive symptoms included headache, irritability, lethargy, vision change; Respiratory symptoms included cough and dyspnea; ECG electrocardiogram; PICU pediatric intensive care unit; NT-proBNP N‐terminal-prohormone B‐type natriuretic peptide; CK creatine kinase; LDH lactate dehydrogenase; ALT alanine aminotransferase; AST aspartate aminotransferase; CRP c-reactive protein; ESR erythrocyte sedimentation rate; WBCs white blood cell counts; RT-PCR reverse transcription-polymerase chain reaction; Ig immunoglobulins; Anti-TNF anti-tumor necrosis