Characteristic of COVID-19 pediatric patients: evidence from systematic review

ABSTRACT

Introduction. The SARS-CoV-2 infection pandemic has affected virtually the whole world. Since the outbreak in China, countries on all continents have been progressively infected, and COVID-19 represents a major challenge to healthcare systems even in highly developed countries. Children are a very special group, largely due to close family contacts, and may be susceptible to cross-infection. Children, generally, have low immunity and some exhibit a long incubation period after SARS-CoV-2 infection. Therefore, children should try to avoid contact with complex populations to avoid being infected by potential spreaders. Aim. The aim of the study was to identify the most frequently observed symptoms in pediatric patients with confirmed COVID-19. Material and methods. We performed a comprehensive systematic literature search of online databases, including PubMed, EMBASE, Web of Science, CENTRAL, from December 2019 to April 10, 2020 to identify all case studies. All the search results were evaluated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The inclusion criterions for the articles were as follows study population pediatric patients with diagnosed COVID-19 (excluding newborn patient);study design: case studies;outcomes measure: at least one outcome reported among clinical symptoms. Results. The analysis of 10 papers reporting 466 pediatric patients with confirmed COVID- 19 revealed that the most frequently observed symptoms are fever (56.0%), cough (49.8%), headache (22.9%), sore throat (22.7%) and fatigue/myalgia (20.3%). The remaining symptoms are much less frequent. In 13.6% of cases, the disease was asymptomatic, and in 40.8% it was mild in clinical classification and in 40.2% moderate type. Relatively rarely children with severe and critical presentation of COVID-19 are observed (3.0 and 1.0%, respectively). Conclusions. The five most frequent symptoms in pediatric patients with confirmed COVID-19 are fever, cough, headache, sore throat and fatigue/myalgia. In the pediatric population, 81% of patients infected with SARS-CoV-2 have mild or moderate symptoms, and only 4% have severe and critical presentation.