SARS-CoV-2 Infection in Children and Newborns: A Systematic Review

Abstract

Abstract A recent outbreak of a novel Coronavirus responsible for a Severe Acute Respiratory Syndrome (SARS-CoV-2) is spreading globally. The aim of this study was to systematically review the existing evidence on SARS-CoV-2 infections in pediatric age.An electronic search was conducted in PubMed database. Papers published between the 1st of January and the 7th of April, 2020 including children aged 0-18 years were selected. Fifty-two studies and two reviews were included, with a total sample size of 4.612 children (2.366 males, 51.3%, weighted mean age 7 years). Patients showed mainly mild (1285/2679, 48.5%) and moderate (1035/2679, 39.1%) signs of the infection. Less than 2% of children were admitted to the Pediatric Intensive Care Unit. The most commonly described symptoms were fever (49.2%) and cough (44.1%). Laboratory findings were often unremarkable. Children underwent a chest CT-scan in 85.7% of all cases, and 36% resulted normal. Overall, the estimated mortality was 0.07%. A higher proportion of newborns was severely ill (17%) and dyspnea was the commonest reported sign (40%). Conclusion: SARS-CoV-2 affects children less severely than adults. Laboratory and radiology findings are mainly nonspecific. Larger epidemiological and clinical cohort studies are needed to better understand possible implications of COVID-19 infection in children.