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Systematic Review of COVID-19 in Children Shows Milder Cases and a Better Prognosis Than Adults

Overview
Journal Acta Paediatr
Specialty Pediatrics
Date 2020 Mar 24
PMID 32202343
Citations 1116
Authors
Affiliations
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Abstract

Aim: The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognosis in children are rare.

Methods: A systematic literature review was carried out to identify papers on COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the MEDLINE and Embase databases between January 1 and March 18, 2020.

Results: The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1%-5% of diagnosed COVID-19 cases, they often have milder disease than adults and deaths have been extremely rare. Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia. Elevated inflammatory markers were less common in children, and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID-19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances.

Conclusions: The coronavirus disease 2019 has occurred in children, but they seemed to have a milder disease course and better prognosis than adults. Deaths were extremely rare.

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References
1.
Li F, Feng Z, Shi Y . Proposal for prevention and control of the 2019 novel coronavirus disease in newborn infants. Arch Dis Child Fetal Neonatal Ed. 2020; 105(6):683-684. PMC: 7133384. DOI: 10.1136/archdischild-2020-318996. View

2.
Ludvigsson J . Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020; 109(6):1088-1095. PMC: 7228328. DOI: 10.1111/apa.15270. View

3.
Xu X, Wu X, Jiang X, Xu K, Ying L, Ma C . Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020; 368:m606. PMC: 7224340. DOI: 10.1136/bmj.m606. View

4.
Simon A, Hollander G, McMichael A . Evolution of the immune system in humans from infancy to old age. Proc Biol Sci. 2015; 282(1821):20143085. PMC: 4707740. DOI: 10.1098/rspb.2014.3085. View

5.
Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W . Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020; 395(10226):809-815. PMC: 7159281. DOI: 10.1016/S0140-6736(20)30360-3. View