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Meta-Analysis
. 2021 Jan;93(1):234-240.
doi: 10.1002/jmv.26208. Epub 2020 Jul 6.

The clinical characteristics of pediatric inpatients with SARS-CoV-2 infection: A meta-analysis and systematic review

Xuefeng Ma  1 , Shousheng Liu  2   3 , Lizhen Chen  1 , Likun Zhuang  2 , Jie Zhang  1 , Yongning Xin  1   2   3
Affiliations
Meta-Analysis

The clinical characteristics of pediatric inpatients with SARS-CoV-2 infection: A meta-analysis and systematic review

Xuefeng Ma et al. J Med Virol. 2021 Jan.

Abstract

Millions of people were infected with the coronavirus disease 2019 (COVID-19) all over the world. Data on clinical symptoms of pediatric inpatients with COVID-19 infection were unclear. The aim of study was to investigate the clinical features of pediatric inpatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. PubMed, EMBASE, and the Cochrane Library were searched to seek for studies providing details on pediatric inpatients with SARS-CoV-2 infection which were published from 1st January to 21st April 2020. Studies with more than five pediatric inpatients were included in our meta-analysis.This study was registered in the PROSPERO database (CRD42020183550). As the results shown, fever (46%) and cough (42%) were the main clinical characters of pediatric inpatients with SARS-CoV-2 infection and the other clinical characters, such as diarrhea, vomiting, nasal congestion, and fatigue account for 10% in pediatric inpatients. The proportion of asymptomatic cases was 0.42 (95% confidence interval [CI]: 0.27-0.59) and severe cases was 0.03 (95% CI: 0.01-0.06). For the laboratory result, leukopenia (21%) and lymphocytosis (22%) were the mainly indicators for pediatric inpatients, followed by high aspartate aminotransferase (19%), lymphopenia (16%), high alanine aminotransferase (15%), high C-reactive protein (17%), leukocytosis (13%), high D-dimer (12%) and high creatine kinase-MB (5%). Regard to chest imaging features, unilateral and bilateral accounts for 22% in pediatric inpatients, respectively. In conclusion, compared with adult inpatients with SARS-CoV-2 infection, the pediatric inpatients had mild clinical characters, lab test indicators, and chest imaging features. More clinical studies focus on the pediatric patients with SARS-CoV-2 infection in other countries should be conducted.

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

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Flow chart of the literature search process
Figure 2
Figure 2
The forest plots of the incidence of clinical features. A, Cough; B, Fever; C, Diarrhea; D, Vomiting; E, Nasal congestion; F, Fatigue. CI, confidence interval
Figure 3
Figure 3
The forest plots of the incidence of imaging features. A, Unilateral; B, bilateral; C, ground‐glass. CI, confidence interval
See this image and copyright information in PMC

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