Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis. Issue 5 (16th February 2021)

• Record Type: Journal Article
• Authors: Irfan, Omar; Muttalib, Fiona; Tang, Kun; Jiang, Li; Lassi, Zohra S; Bhutta, Zulfiqar
• Is Part Of: Archives of disease in childhood. Volume 106:Issue 5(2021)
• Page Start: 440
• Page End: 448
• Publication Date: 2021-02-16
• Subjects: COVID-19 -- adolescent health -- epidemiology; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2020-321385
• Languages: English
• ISSNs: 0003-9888

Abstract

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.