Characterization of COVID-19 Pandemic in Pediatric Age Group: A Systematic Review and Meta-Analysis.
The most frequently reported symptoms were cough 49% and fever 47%. Lymphopenia and procalcitonin elevation were recorded in 21 and 28% of cases, respectively. No gender differences for COVID-19 were found in the pediatric age group (p = 0.7). The mortality rate was 0%. Four of 58 (6.8%) infants born with COVID-19 had disease-positive mothers.
The disease in pediatric patients has a good prognosis compared to adults. Use of intensive care and death are rare.
Vertical transmission and spread of the virus in breast milk has yet to be established
- May 7, 2020. Eurosurveillance. Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020
- The multicentre study involves 11 of the 13 exclusively pediatric hospitals and 51 of the 390 pediatric units throughout Italy, mainly in the central and northern regions.
- Data includes all pediatric patients in whom COVID-19 has been documented using at least one positive nasal / throat swab specimen using the RT-PCR test.
There are 168 laboratory confirmed pediatric cases (median: 2.3 years, range: 1 day-17.7 years, 55.9% male), of which 67.9% were hospitalized and 19.6 % had comorbidities. Fever was the most common symptom, gastrointestinal manifestations frequent. Two children required intensive care, five had seizures, 49 received experimental treatments and all recovered.
May 1, 2020. NEJM. In children, as recently confirmed by an Italian series of children who have had access to the Emergency Department (Children with Covid-19 in Pediatric Emergency Departments in Italy), we can confirm that Covid-19 infection does not occur in the vast majority of cases with severe symptoms.22 April 2020. JAMA Pediatrics.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents. A Systematic ReviewThe systematic review by Italian researchers published in Jama Pediatrics selected the articles that met the following inclusion criteria:
- Population: children and adolescents (ages 0-19) with confirmed nasopharyngeal swab infection
- Study design: retrospective studies, bulletins and national reports
- Results: evaluation of clinical symptoms, description of sources and mechanisms of spread of infection, description of diagnostic tests and therapeutic strategies, prognosis
From 815 initial articles, 18 were those considered in the analysis, for a total of 1,065 patients with confirmed nasopharyngeal swab infection (444 patients were under 10 years old and 553 were between 10 and 19 years old).
Studies show that children of all ages either experienced mild respiratory symptoms, namely fever, dry cough and fatigue, or were asymptomatic. In cases where chest radiography was performed, bronchial thickening and ground glass opacifications were found and these findings have also been reported in asymptomatic patients.
No deaths have been reported in children 0 to 9 years old.
In general, all patients had a good prognosis; however, one death has been reported between the ages of 10 and 19. Data on therapies are rather limited. Patients with mild respiratory symptoms, pneumonia and fever were treated with antibiotics and supportive care. None of the patients required oxygen therapy.