Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 3;71(9):2469-2479.
doi: 10.1093/cid/ciaa556.

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

Nisha S Mehta  1 , Oliver T Mytton  2 , Edward W S Mullins  3   4 , Tom A Fowler  5 , Catherine L Falconer  6 , Orla B Murphy  1 , Claudia Langenberg  7   8   9 , Wikum J P Jayatunga  1 , Danielle H Eddy  8 , Jonathan S Nguyen-Van-Tam  1   10
Affiliations

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

Nisha S Mehta et al. Clin Infect Dis. .

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.

Keywords: COVID-19; SARS-CoV-2; children; coronavirus; infection.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
PRISMA 2009 flow diagram [13]. Abbreviations: COVID-19, coronavirus disease 2019; HDAS, Healthcare Databases Advanced Search; MERS-CoV, Middle East respiratory syndrome coronavirus; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SARS-CoV, severe acute respiratory syndrome coronavirus; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; WHO, World Health Organization.
See this image and copyright information in PMC

Comment in

Similar articles

  • Human and novel coronavirus infections in children: a review.
    Rajapakse N, Dixit D. Rajapakse N, et al. Paediatr Int Child Health. 2021 Feb;41(1):36-55. doi: 10.1080/20469047.2020.1781356. Epub 2020 Jun 25. Paediatr Int Child Health. 2021. PMID: 32584199 Review.
  • COVID-19 infection in children with blood cancer: A systematic review.
    Alhumaid S, Al Noaim K, Almuslim AA, Turkistani JA, Alqurini ZS, Alshakhs AM, Al Dossary N, Alabdulqader M, Majzoub RA, Alnaim AA, Alahmari AA, Al Ghamdi MA, Alabdulmohsen W, Alsharidah ZA, Alkhamees MS, AlAithan LA, Almurayhil AA, Almurayhil YA, Aljubran HA, Alhamdan ZS, Shabib MA, Aldandan AW, Allowaim AA, Al-Rasasi AY, Albahrani AA, Al Salem BA, Bukhamseen MS, Al Ayeyd JS, Al Mutair A, Alhumaid H, Al Alawi Z, Rabaan AA. Alhumaid S, et al. Ann Hematol. 2025 Feb;104(2):1203-1230. doi: 10.1007/s00277-024-06057-4. Epub 2024 Nov 5. Ann Hematol. 2025. PMID: 39496811 Free PMC article.
  • Children and Adolescents With SARS-CoV-2 Infection: Epidemiology, Clinical Course and Viral Loads.
    Maltezou HC, Magaziotou I, Dedoukou X, Eleftheriou E, Raftopoulos V, Michos A, Lourida A, Panopoulou M, Stamoulis K, Papaevangelou V, Petinaki E, Mentis A, Papa A, Tsakris A, Roilides E, Syrogiannopoulos GA, Tsolia M; for Greek Study Group on SARS-CoV-2 Infections in Children. Maltezou HC, et al. Pediatr Infect Dis J. 2020 Dec;39(12):e388-e392. doi: 10.1097/INF.0000000000002899. Pediatr Infect Dis J. 2020. PMID: 33031141
  • Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.
    Crider K, Williams J, Qi YP, Gutman J, Yeung L, Mai C, Finkelstain J, Mehta S, Pons-Duran C, Menéndez C, Moraleda C, Rogers L, Daniels K, Green P. Crider K, et al. Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217. Cochrane Database Syst Rev. 2022. PMID: 36321557 Free PMC article.
  • Transmission dynamics of SARS-CoV-2 within families with children in Greece: A study of 23 clusters.
    Maltezou HC, Vorou R, Papadima K, Kossyvakis A, Spanakis N, Gioula G, Exindari M, Metallidis S, Lourida AN, Raftopoulos V, Froukala E, Martinez-Gonzalez B, Mitsianis A, Roilides E, Mentis A, Tsakris A, Papa A. Maltezou HC, et al. J Med Virol. 2021 Mar;93(3):1414-1420. doi: 10.1002/jmv.26394. Epub 2020 Aug 26. J Med Virol. 2021. PMID: 32767703 Free PMC article.
See all similar articles

Cited by

See all "Cited by" articles

References

    1. Li Q, Guan X, Wu P, et al. . Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020:1–9. doi:10.1056/NEJMoa2001316. - DOI - PMC - PubMed
    1. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report–51. World Health Organization, 11 March 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2.... Accessed 12 March 2020.
    1. Ison MG, Lee N. Noninfluenza respiratory viruses. In: Cohen J, Powderly W, Opal S, eds. Infectious diseases. 4th ed. Vol. 22017 London: Elsevier, 2017:1472–82.
    1. World Health Organization, Department of Communicable Disease Surveillance and Response. Consensus document on the epidemiology of severe acute respiratory syndrome (SARS) World Health Organization, 2003. Available at: https://www.who.int/csr/sars/en/WHOconsensus.pdf. Accessed 9 March 2020.
    1. World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV), MERS Monthly Summary, November 2019 World Health Organization, 2019. Available at: https://www.who.int/emergencies/mers-cov/en/. Accessed 9 March 2020.

Publication types