SARS-CoV-2 (COVID-19): What Do We Know About Children? A Systematic Review

Author:

Mehta Nisha S1,Mytton Oliver T2,Mullins Edward W S34,Fowler Tom A5,Falconer Catherine L6,Murphy Orla B1,Langenberg Claudia789ORCID,Jayatunga Wikum J P1ORCID,Eddy Danielle H8,Nguyen-Van-Tam Jonathan S110

Affiliation:

1. Department of Health and Social Care (England), London, United Kingdom

2. University of Cambridge, Cambridge, United Kingdom

3. Imperial College London, London, United Kingdom

4. Obstetrics and Gynecology, Queen Charlotte’s and Chelsea Hospital, London, United Kingdom

5. Genomics England, London, United Kingdom

6. Somerset County Council, Taunton, United Kingdom

7. MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom

8. Public Health England, London, United Kingdom

9. The Francis Crick Institute, London, United Kingdom

10. University of Nottingham School of Medicine, Nottingham, United Kingdom

Abstract

Abstract Background Few pediatric cases of coronavirus disease 2019 (COVID-19) have been reported and we know little about the epidemiology in children, although more is known about other coronaviruses. We aimed to understand the infection rate, clinical presentation, clinical outcomes, and transmission dynamics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in order to inform clinical and public health measures. Methods We undertook a rapid systematic review and narrative synthesis of all literature relating to SARS-CoV-2 in pediatric populations. The search terms also included SARS-CoV and MERS-CoV. We searched 3 databases and the COVID-19 resource centers of 11 major journals and publishers. English abstracts of Chinese-language papers were included. Data were extracted and narrative syntheses conducted. Results Twenty-four studies relating to COVID-19 were included in the review. Children appear to be less affected by COVID-19 than adults by observed rate of cases in large epidemiological studies. Limited data on attack rate indicate that children are just as susceptible to infection. Data on clinical outcomes are scarce but include several reports of asymptomatic infection and a milder course of disease in young children, although radiological abnormalities are noted. Severe cases are not reported in detail and there are few data relating to transmission. Conclusions Children appear to have a low observed case rate of COVID-19 but may have rates similar to adults of infection with SARS-CoV-2. This discrepancy may be because children are asymptomatic or too mildly infected to draw medical attention and be tested and counted in observed cases of COVID-19.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference40 articles.

1. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia;Li;N Engl J Med,2020

2. Noninfluenza respiratory;Ison,2017

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