Cargando…
Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis
OBJECTIVE: Compare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity. DESIGN: Systematic review and meta-analysis. SETTING: Between 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers co...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070630/ https://www.ncbi.nlm.nih.gov/pubmed/33593743 http://dx.doi.org/10.1136/archdischild-2020-321385 |
_version_ | 1783683515082080256 |
---|---|
author | Irfan, Omar Muttalib, Fiona Tang, Kun Jiang, Li Lassi, Zohra S Bhutta, Zulfiqar |
author_facet | Irfan, Omar Muttalib, Fiona Tang, Kun Jiang, Li Lassi, Zohra S Bhutta, Zulfiqar |
author_sort | Irfan, Omar |
collection | PubMed |
description | OBJECTIVE: Compare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity. DESIGN: Systematic review and meta-analysis. SETTING: Between 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers conducted study screening, data abstraction and quality assessment independently and in duplicate. Observational studies describing laboratory-confirmed paediatric (0–19 years old) COVID-19 were considered for inclusion. MAIN OUTCOMES AND MEASURES: The pooled proportions of clinical findings, treatment and outcomes were compared according to World Bank country income level and reported disease severity. RESULTS: 129 studies were included from 31 countries comprising 10 251 children of which 57.4% were hospitalised. Mean age was 7.0 years (SD 3.6), and 27.1% had a comorbidity. Fever (63.3%) and cough (33.7%) were common. Of 3670 cases, 44.1% had radiographic abnormalities. The majority of cases recovered (88.9%); however, 96 hospitalised children died. Compared with high-income countries, in low-income and middle-income countries, a lower proportion of cases were admitted to intensive care units (ICUs) (9.9% vs 26.0%) yet pooled proportion of deaths among hospitalised children was higher (relative risk 2.14, 95% CI 1.43 to 3.20). Children with severe disease received antimicrobials, inotropes and anti-inflammatory agents more frequently than those with non-severe disease. Subgroup analyses showed that a higher proportion of children with multisystem inflammatory syndrome (MIS-C) were admitted to ICU (47.1% vs 22.9%) and a higher proportion of hospitalised children with MIS-C died (4.8% vs 3.6%) compared with the overall sample. CONCLUSION: Paediatric COVID-19 has a favourable prognosis. Further severe disease characterisation in children is needed globally. |
format | Online Article Text |
id | pubmed-8070630 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-80706302021-05-11 Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis Irfan, Omar Muttalib, Fiona Tang, Kun Jiang, Li Lassi, Zohra S Bhutta, Zulfiqar Arch Dis Child Global Child Health OBJECTIVE: Compare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity. DESIGN: Systematic review and meta-analysis. SETTING: Between 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers conducted study screening, data abstraction and quality assessment independently and in duplicate. Observational studies describing laboratory-confirmed paediatric (0–19 years old) COVID-19 were considered for inclusion. MAIN OUTCOMES AND MEASURES: The pooled proportions of clinical findings, treatment and outcomes were compared according to World Bank country income level and reported disease severity. RESULTS: 129 studies were included from 31 countries comprising 10 251 children of which 57.4% were hospitalised. Mean age was 7.0 years (SD 3.6), and 27.1% had a comorbidity. Fever (63.3%) and cough (33.7%) were common. Of 3670 cases, 44.1% had radiographic abnormalities. The majority of cases recovered (88.9%); however, 96 hospitalised children died. Compared with high-income countries, in low-income and middle-income countries, a lower proportion of cases were admitted to intensive care units (ICUs) (9.9% vs 26.0%) yet pooled proportion of deaths among hospitalised children was higher (relative risk 2.14, 95% CI 1.43 to 3.20). Children with severe disease received antimicrobials, inotropes and anti-inflammatory agents more frequently than those with non-severe disease. Subgroup analyses showed that a higher proportion of children with multisystem inflammatory syndrome (MIS-C) were admitted to ICU (47.1% vs 22.9%) and a higher proportion of hospitalised children with MIS-C died (4.8% vs 3.6%) compared with the overall sample. CONCLUSION: Paediatric COVID-19 has a favourable prognosis. Further severe disease characterisation in children is needed globally. BMJ Publishing Group 2021-05 2021-02-16 /pmc/articles/PMC8070630/ /pubmed/33593743 http://dx.doi.org/10.1136/archdischild-2020-321385 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Global Child Health Irfan, Omar Muttalib, Fiona Tang, Kun Jiang, Li Lassi, Zohra S Bhutta, Zulfiqar Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis |
title | Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis |
title_full | Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis |
title_fullStr | Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis |
title_full_unstemmed | Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis |
title_short | Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis |
title_sort | clinical characteristics, treatment and outcomes of paediatric covid-19: a systematic review and meta-analysis |
topic | Global Child Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070630/ https://www.ncbi.nlm.nih.gov/pubmed/33593743 http://dx.doi.org/10.1136/archdischild-2020-321385 |
work_keys_str_mv | AT irfanomar clinicalcharacteristicstreatmentandoutcomesofpaediatriccovid19asystematicreviewandmetaanalysis AT muttalibfiona clinicalcharacteristicstreatmentandoutcomesofpaediatriccovid19asystematicreviewandmetaanalysis AT tangkun clinicalcharacteristicstreatmentandoutcomesofpaediatriccovid19asystematicreviewandmetaanalysis AT jiangli clinicalcharacteristicstreatmentandoutcomesofpaediatriccovid19asystematicreviewandmetaanalysis AT lassizohras clinicalcharacteristicstreatmentandoutcomesofpaediatriccovid19asystematicreviewandmetaanalysis AT bhuttazulfiqar clinicalcharacteristicstreatmentandoutcomesofpaediatriccovid19asystematicreviewandmetaanalysis |