Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Systematic Review Article

COVID-19 in Pediatrics: A Systematic Review of Current Knowledge and Practice

Author(s): Esmaeil Mehraeen, Shahram Oliaei, SeyedAhmad SeyedAlinaghi*, Amirali Karimi, Pegah Mirzapour, Amir Masoud Afsahi, Alireza Barzegary, Farzin Vahedi, Mahdi Soleymanzadeh, Farzane Behnezhad, Mohammad Javaherian, Ghazal Zargari, Seyed Peyman Mirghaderi, Tayebeh Noori and Jean-Marc Sabatier

Volume 22, Issue 5, 2022

Published on: 18 April, 2022

Article ID: e290921196908 Pages: 11

DOI: 10.2174/1871526521666210929121705

Price: $65

conference banner
Abstract

Introduction: SARS-CoV-2 is the novel coronavirus that causes severe acute respiratory syndrome and could afflict individuals from all walks of life. Children are usually asymptomatic or represent non-specific mild to moderate symptoms; therefore, they often remain undiagnosed and could be potential reservoirs and silent carriers of the virus. Despite the global attention to COVID-19 and its importance in public health, some clinical and paraclinical aspects of this disease in children are still unclear. Thus, we conducted a comprehensive systematic review of available literature to reflect on the current knowledge and practice of the disease among children.

Methods: This study was a systematic review of current evidence conducted in October 2020. We performed a systematic search using the keywords in online databases. The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of extracted literature and results.

Results: We selected and reviewed 23 most related studies out of 1744 identified papers in an initial online search based on the inclusion and exclusion criteria of the present review; of whom 13 were original research studies, and 10 were letters to the editors, commentaries, viewpoints, consensus statements, and perspectives. Although due to the origin of the current pandemic, China was the country with the most publications (12 articles), data from several countries have been included in this review.

Conclusion: COVID-19 can also affect children and cause systemic disease with several internal organ involvements. However, the prevalence, severity, and diversity of the symptoms in children are less than in adults. Cough and fever appear to be some of the most common symptoms, followed by other symptoms such as gastrointestinal manifestations. Comorbidities increase the risk of severe COVID-19 in children, and those without underlying conditions are very unlikely to suffer from severe disease. Mental health issues such as anxiety and depression due to the isolated situation caused by pandemics are common findings in children of early ages and should be seriously considered in current practice.

Keywords: COVID-19, SARS-CoV-2, coronavirus, morbidity, mortality, pediatrics, prognosis.

Graphical Abstract
[1]
Sohrabi C, Alsafi Z, O’Neill N, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020; 76: 71-6.
[http://dx.doi.org/10.1016/j.ijsu.2020.02.034] [PMID: 32112977]
[2]
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382(8): 727-33.
[http://dx.doi.org/10.1056/NEJMoa2001017] [PMID: 31978945]
[3]
Mehraeen E, Seyed Alinaghi SA, Nowroozi A, et al. A systematic review of ECG findings in patients with COVID-19. Indian Heart J 2020; 72(6): 500-7.
[http://dx.doi.org/10.1016/j.ihj.2020.11.007] [PMID: 33357637]
[4]
The World Health Organization (WHO). WHO director-general's statement on IHR emergency committee on novel coronavirus (2019- nCoV). 2020. 2020. Availalble from: https://www.who.int/director-general/speeches/detail/who-director-general-s-statement-on-ihr-emergency-committee-on-novel-coronavirus
[5]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229): 1054-62.
[http://dx.doi.org/10.1016/S0140-6736(20)30566-3] [PMID: 32171076]
[6]
Mehraeen E, Karimi A, Barzegary A, et al. Predictors of mortality in patients with COVID-19-a systematic review. Eur J Integr Med 2020; 40: 101226.
[http://dx.doi.org/10.1016/j.eujim.2020.101226] [PMID: 33101547]
[7]
SeyedAlinaghi S, Karimi A, Shobeiri P, et al. Psychological symptoms of COVID-19 epidemic: A systematic review of current evidence. Psihologija (Beogr) 2021; 54(2): 173-92.
[8]
Gao Z, Xu Y, Sun C, Wang X, Guo Y, Qiu S, et al. A systematic review of asymptomatic infections with COVID-19. J Microbiol Immunol Infect 2021; 54(1): 12-6.
[9]
Baj J. Karakuła-Juchnowicz H, Teresiński G, et al. COVID-19: Specific and non-specific clinical manifestations and symptoms: The current state of knowledge. J Clin Med 2020; 9(6): 1753.
[http://dx.doi.org/10.3390/jcm9061753] [PMID: 32516940]
[10]
Fu L, Wang B, Yuan T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect 2020; 80(6): 656-65.
[http://dx.doi.org/10.1016/j.jinf.2020.03.041] [PMID: 32283155]
[11]
Sun P, Qie S, Liu Z, Ren J, Li K, Xi J. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis. J Med Virol 2020; 92(6): 612-7.
[http://dx.doi.org/10.1002/jmv.25735] [PMID: 32108351]
[12]
Tu H, Tu S, Gao S, Shao A, Sheng J. Current epidemiological and clinical features of COVID-19; a global perspective from China. J Infect 2020; 81(1): 1-9.
[http://dx.doi.org/10.1016/j.jinf.2020.04.011] [PMID: 32315723]
[13]
Shahid Z, Kalayanamitra R, McClafferty B, et al. COVID-19 and older adults: What we know. J Am Geriatr Soc 2020; 68(5): 926-9.
[http://dx.doi.org/10.1111/jgs.16472] [PMID: 32255507]
[14]
Rod JE, Oviedo-Trespalacios O, Cortes-Ramirez J. A brief-review of the risk factors for COVID-19 severity. Rev Saude Publica 2020; 54: 60.
[http://dx.doi.org/10.11606/s1518-8787.2020054002481] [PMID: 32491116]
[15]
Wei M, Yuan J, Liu Y, Fu T, Yu X, Zhang Z-J. Novel coronavirus infection in hospitalized infants under 1 year of age in China. JAMA 2020; 323(13): 1313-4.
[http://dx.doi.org/10.1001/jama.2020.2131] [PMID: 32058570]
[16]
Ghiasvand F, Miandoab SZ, Harandi H, Golestan FS, Alinaghi SAS. A patient with covid-19 disease in a referral hospital in Iran: A typical case. Infect Disord Drug Targets 2020; 20(4): 559-62.
[http://dx.doi.org/10.2174/1871526520666200429115535] [PMID: 32348232]
[17]
Assaker R, Colas A-E, Julien-Marsollier F, et al. Presenting symptoms of COVID-19 in children: a meta-analysis of published studies. Br J Anaesth 2020; 125(3): e330-2.
[http://dx.doi.org/10.1016/j.bja.2020.05.026] [PMID: 32534738]
[18]
Perikleous E, Tsalkidis A, Bush A, Paraskakis E. Coronavirus global pandemic: An overview of current findings among pediatric patients. Pediatr Pulmonol 2020; 55(12): 3252-67.
[http://dx.doi.org/10.1002/ppul.25087] [PMID: 32965785]
[19]
Nakra NA, Blumberg DA, Herrera-Guerra A, Lakshminrusimha S. Multi-system inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: Review of clinical presentation, hypothetical pathogenesis, and proposed management. Children (Basel) 2020; 7(7): E69.
[http://dx.doi.org/10.3390/children7070069] [PMID: 32630212]
[20]
Dhochak N, Singhal T, Kabra SK, Lodha R. Pathophysiology of COVID-19: Why children fare better than adults? Indian J Pediatr 2020; 87(7): 537-46.
[http://dx.doi.org/10.1007/s12098-020-03322-y] [PMID: 32410003]
[21]
Sinaei R, Pezeshki S, Parvaresh S, Sinaei R. Why COVID-19 is less frequent and severe in children: a narrative review. World J Pediatr 2021; 17(1): 10-20.
[http://dx.doi.org/10.1007/s12519-020-00392-y] [PMID: 32978651]
[22]
Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatrica (Oslo, Norway : 1992) 2020; 109(6): 1088-95.
[23]
Tezer H. Bedir Demirdağ T. Novel coronavirus disease (COVID-19) in children. Turk J Med Sci 2020; 50(SI-1): 592-603.
[http://dx.doi.org/10.3906/sag-2004-174] [PMID: 32304191]
[24]
Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health 2020; 14: 20.
[http://dx.doi.org/10.1186/s13034-020-00329-3] [PMID: 32419840]
[25]
Lu Q, Shi Y. Coronavirus disease (COVID-19) and neonate: What neonatologist need to know. J Med Virol 2020; 92(6): 564-7.
[http://dx.doi.org/10.1002/jmv.25740] [PMID: 32115733]
[26]
Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020; 20(6): 689-96.
[http://dx.doi.org/10.1016/S1473-3099(20)30198-5] [PMID: 32220650]
[27]
Rahimzadeh G, Ekrami NM, Kadkhodaei EF, et al. COVID-19 infection in Iranian children: A case series of 9 patients. JPR 2020; 8(2): 139-44.
[http://dx.doi.org/10.32598/jpr.8.2.139]
[28]
She J, Liu L, Liu W. COVID-19 epidemic: Disease characteristics in children. J Med Virol 2020; 92(7): 747-54.
[http://dx.doi.org/10.1002/jmv.25807] [PMID: 32232980]
[29]
Shekerdemian LS, Mahmood NR, Wolfe KK, et al. Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units. JAMA Pediatr 2020; 174(9): 868-73.
[http://dx.doi.org/10.1001/jamapediatrics.2020.1948] [PMID: 32392288]
[30]
CDC. COVID-19 Response Team. Coronavirus disease 2019 in children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep 2020; 69(14): 422-6.
[http://dx.doi.org/10.15585/mmwr.mm6914e4] [PMID: 32271728]
[31]
Song W, Li J, Zou N, Guan W, Pan J, Xu W. Clinical features of pediatric patients with coronavirus disease (COVID-19). J Clin Virol 2020; 127: 104377.
[http://dx.doi.org/10.1016/j.jcv.2020.104377] [PMID: 32361323]
[32]
Su L, Ma X, Yu H, et al. The different clinical characteristics of corona virus disease cases between children and their families in China - the character of children with COVID-19. Emerg Microbes Infect 2020; 9(1): 707-13.
[http://dx.doi.org/10.1080/22221751.2020.1744483] [PMID: 32208917]
[33]
Sun D, Li H, Lu X-X, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr 2020; 16(3): 251-9.
[http://dx.doi.org/10.1007/s12519-020-00354-4] [PMID: 32193831]
[34]
Tagarro A, Epalza C, Santos M, et al. Screening and severity of coronavirus disease 2019 (COVID-19) in children in Madrid, Spain. JAMA Pediatr 2020; 2020: e201346.
[http://dx.doi.org/10.1001/jamapediatrics.2020.1346] [PMID: 32267485]
[35]
Tan Y-P, Tan B-Y, Pan J, Wu J, Zeng S-Z, Wei H-Y. Epidemiologic and clinical characteristics of 10 children with coronavirus disease 2019 in Changsha, China. J Clin Virol 2020; 127: 104353.
[http://dx.doi.org/10.1016/j.jcv.2020.104353] [PMID: 32302953]
[36]
Wang Y, Zhu L-Q. Pharmaceutical care recommendations for antiviral treatments in children with coronavirus disease 2019. World J Pediatr 2020; 16(3): 271-4.
[http://dx.doi.org/10.1007/s12519-020-00353-5] [PMID: 32166483]
[37]
Zheng F, Liao C, Fan QH, et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci 2020; 40(2): 275-80.
[http://dx.doi.org/10.1007/s11596-020-2172-6] [PMID: 32207032]
[38]
Golberstein E, Wen H, Miller BF. Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA Pediatr 2020; 174(9): 819-20.
[http://dx.doi.org/10.1001/jamapediatrics.2020.1456] [PMID: 32286618]
[39]
Hong H, Wang Y, Chung HT, Chen CJ. Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children. Pediatr Neonatol 2020; 61(2): 131-2.
[http://dx.doi.org/10.1016/j.pedneo.2020.03.001] [PMID: 32199864]
[40]
Lee PI, Hu YL, Chen PY, Huang YC, Hsueh PR. Are children less susceptible to COVID-19? J Microbiol Immunol Infect 2020; 53(3): 371-2.
[41]
Cruz AT, Zeichner SL. COVID-19 in children: Initial characterization of the pediatric disease. Pediatrics 2020; 145(6): e20200834.
[http://dx.doi.org/10.1542/peds.2020-0834] [PMID: 32179659]
[42]
Eastin C, Eastin T, Dong Y, Mo X, Hu Y. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020. J Emerg Med 2020; 58(4): 712-3.
[http://dx.doi.org/10.1542/peds.2020-0702]
[43]
Kelvin AA, Halperin S. COVID-19 in children: the link in the transmission chain. Lancet Infect Dis 2020; 20(6): 633-4.
[http://dx.doi.org/10.1016/S1473-3099(20)30236-X] [PMID: 32220651]
[44]
Lee B, Raszka WV Jr. COVID-19 transmission and children: The child is not to blame. Pediatrics 2020; 146(2): e2020004879.
[http://dx.doi.org/10.1542/peds.2020-004879] [PMID: 32457212]
[45]
Liu W, Zhang Q, Chen J, et al. Detection of covid-19 in children in early january 2020 in Wuhan, China. N Engl J Med 2020; 382(14): 1370-1.
[http://dx.doi.org/10.1056/NEJMc2003717] [PMID: 32163697]
[46]
Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med 2020; 58(7): 1135-8.
[http://dx.doi.org/10.1515/cclm-2020-0272] [PMID: 32172227]
[47]
Yang P, Liu P, Li D, Zhao D. Corona virus disease 2019, a growing threat to children? J Infect 2020; 80(6): 671-93.
[http://dx.doi.org/10.1016/j.jinf.2020.02.024] [PMID: 32142929]
[48]
Patel NA. Pediatric COVID-19: Systematic review of the literature. Am J Otolaryngol 2020; 41(5): 102573.
[http://dx.doi.org/10.1016/j.amjoto.2020.102573] [PMID: 32531620]
[49]
Leung CW, Chiu WK. Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children. Paediatr Respir Rev 2004; 5(4): 275-88.
[http://dx.doi.org/10.1016/j.prrv.2004.07.010] [PMID: 15531251]
[50]
Wang Z, Li X, Li D, Li Y. Clinical features of 167 children with the novel influenza A (H1N1) virus infection in Xi’an, China. Turk J Pediatr 2012; 54(2): 99-104.
[PMID: 22734294]
[51]
Ludvigsson JF. Children are unlikely to be the main drivers of the COVID-19 pandemic - A systematic review. Acta Paediatr 2020; 109(8): 1525-30.
[http://dx.doi.org/10.1111/apa.15371] [PMID: 32430964]
[52]
Jones TC, Mühlemann B, Veith T, et al. An analysis of SARS-CoV-2 viral load by patient age. medRxiv 2020; 2020.06.08.20125484.
[53]
Cao Q, Chen Y-C, Chen C-L, Chiu C-H. SARS-CoV-2 infection in children: Transmission dynamics and clinical characteristics. J Formos Med Assoc 2020; 119(3): 670-3.
[http://dx.doi.org/10.1016/j.jfma.2020.02.009] [PMID: 32139299]
[54]
Tian S, Wu M, Chang Z, et al. Epidemiological investigation and intergenerational clinical characteristics of 24 coronavirus disease patients associated with a supermarket cluster: a retrospective study. BMC Public Health 2021; 21(1): 647.
[http://dx.doi.org/10.1186/s12889-021-10713-z] [PMID: 33794836]
[55]
Mehraeen E, Salehi MA, Behnezhad F, Moghaddam HR. SeyedAlinaghi S. Transmission modes of covid-19: A systematic review. Infect Disord Drug Targets 2021; 21(6): e170721187995.
[http://dx.doi.org/10.2174/1871526520666201116095934] [PMID: 33200716]
[56]
Bi Q, Wu Y, Mei S, et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. Lancet Infect Dis 2020; 20(8): 911-9.
[http://dx.doi.org/10.1016/S1473-3099(20)30287-5] [PMID: 32353347]
[57]
Hoang A, Chorath K, Moreira A, et al. COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine 2020; 24: 100433.
[http://dx.doi.org/10.1016/j.eclinm.2020.100433] [PMID: 32766542]
[58]
Mantovani A, Rinaldi E, Zusi C, Beatrice G, Saccomani MD, Dalbeni A. Coronavirus disease 2019 (COVID-19) in children and/or adolescents: a meta-analysis. Pediatr Res 2021; 89(4): 733-7.
[http://dx.doi.org/10.1038/s41390-020-1015-2] [PMID: 32555539]
[59]
Iannarella R, Lattanzi C, Cannata G, et al. Coronavirus infections in children: from SARS and MERS to COVID-19, a narrative review of epidemiological and clinical features. Acta Biomed 2020; 91(3): e2020032.
[PMID: 32921726]
[60]
Cheung EW, Zachariah P, Gorelik M, et al. Multisystem inflammatory syndrome related to covid-19 in previously healthy children and adolescents in New York city. JAMA 2020; 324(3): 294-6.
[http://dx.doi.org/10.1001/jama.2020.10374] [PMID: 32511676]
[61]
Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med 2020; 26(7): 1017-32.
[http://dx.doi.org/10.1038/s41591-020-0968-3] [PMID: 32651579]
[62]
Naicker S, Yang C-W, Hwang S-J, Liu B-C, Chen J-H, Jha V. The novel coronavirus 2019 epidemic and kidneys. Kidney Int 2020; 97(5): 824-8.
[http://dx.doi.org/10.1016/j.kint.2020.03.001] [PMID: 32204907]
[63]
Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020; 97(5): 829-38.
[http://dx.doi.org/10.1016/j.kint.2020.03.005] [PMID: 32247631]
[64]
Mehraeen E, Dadras O, Afsahi AM, et al. Vaccines for COVID-19: A systematic review of feasibility and effectiveness. Infect Disord Drug Targets 2022; 22(2): e230921196758.
[http://dx.doi.org/10.2174/1871526521666210923144837] [PMID: 34554905]
[65]
SeyedAlinaghi S, Mirzapour P, Dadras O, et al. Characterization of SARS-CoV-2 different variants and related morbidity and mortality: a systematic review. Eur J Med Res 2021; 26(1): 51.
[http://dx.doi.org/10.1186/s40001-021-00524-8] [PMID: 34103090]
[66]
SeyedAlinaghi S, Mehrtak M, MohsseniPour M, et al. Genetic susceptibility of COVID-19: a systematic review of current evidence. Eur J Med Res 2021; 26(1): 46.
[http://dx.doi.org/10.1186/s40001-021-00516-8] [PMID: 34016183]
[67]
SeyedAlinaghi S, Abbasian L, Solduzian M, et al. Predictors of the prolonged recovery period in COVID-19 patients: a cross-sectional study. Eur J Med Res 2021; 26(1): 41.
[http://dx.doi.org/10.1186/s40001-021-00513-x] [PMID: 33957992]
[68]
SeyedAlinaghi S, Afsahi AM, MohsseniPour M, et al. Late complications of COVID-19; a systematic review of current evidence. Arch Acad Emerg Med 2021; 9(1): e14.
[http://dx.doi.org/10.22037/aaem.v9i1.1058] [PMID: 33681819]
[69]
Esfahanian F. SeyedAlinaghi S, Janfaza N, Tantuoyir MM. Predictors of hospital mortality among patients with COVID-19 in Tehran, Iran. SAGE Open Med 2021; 9: 20503121211051573.
[http://dx.doi.org/10.1177/20503121211051573] [PMID: 34676075]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy