COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings

Arch Pediatr. 2021 Apr;28(3):242-248. doi: 10.1016/j.arcped.2020.12.008. Epub 2021 Jan 9.

Abstract

Objective: We aimed to provide a meta-analysis of previously published papers on the COVID-19-related clinical features and laboratory findings in children.

Method: This meta-analysis was conducted by using Medline/PubMed, Scopus, Web of Sciences and Google Scholar. Finally, 32 articles were selected for full-text assessment.

Results: The most frequent symptoms were fever, cough, vomiting, diarrhea, sore throat, and dyspnea. Regarding the combined results of the meta-analysis, fever (46%, 95% CI 40-53%), cough (37%, 95% CI 29-46%), diarrhea (19%, 95% CI 9-28%), and pharyngalgia (13%, 95% CI 5-20%) were the most widely reported symptom. Besides, positive RT-PCR test results (43%, 95% CI 33-53%), low oxygen saturation (38%, 95% CI 25-51%), and elevated D-dimer levels (36%, 95% CI 16-56%) were the most common laboratory findings.

Conclusion: This review found that clinical presentations were milder, the prognosis was better, and the mortality rate was lower in children with COVID-19 compared with adult patients; however, children are potential carriers, like adults, and can transmit the infection among the population. Therefore, early identification and intervention in pediatric patients with COVID-19 are essential in order to control the pandemic. Moreover, gastrointestinal symptoms were more common symptoms among children.

Keywords: Children; Clinical symptom; Coronavirus disease 2019; Laboratory features; Meta-analysis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 / complications
  • COVID-19 / diagnosis*
  • COVID-19 Testing
  • Child
  • Humans
  • Prognosis
  • Severity of Illness Index
  • Symptom Assessment