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Review
. 2020 Sep 7;91(3):e2020032.
doi: 10.23750/abm.v91i3.10294.

Coronavirus infections in children: from SARS and MERS to COVID-19, a narrative review of epidemiological and clinical features

Rosanna Iannarella  1 , Claudia Lattanzi  2 , Giulia Cannata  3 , Alberto Argentiero  4 , Cosimo Neglia  5 , Valentina Fainardi  6 , Giovanna Pisi  7 , Susanna Esposito  8
Affiliations
Review

Coronavirus infections in children: from SARS and MERS to COVID-19, a narrative review of epidemiological and clinical features

Rosanna Iannarella et al. Acta Biomed. .

Abstract

Emerging and re-emerging viruses represent an important challenge for global public health. In the 1960s, coronaviruses (CoVs) were recognized as disease agents in humans. In only two decades, three strains of CoVs have crossed species barriers rapidly emerging as human pathogens resulting in life-threatening disease with a pandemic potential: severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002, Middle-East respiratory syndrome coronavirus (MERS-CoV) in 2012 and the recently emerged SARS-CoV-2. This narrative review aims to provide a comprehensive overview of epidemiological, pathogenic and clinical features, along with diagnosis and treatment, of the ongoing epidemic of new coronavirus disease 2019 (COVID-19) in the pediatric population in comparison to the first two previous deadly coronavirus outbreaks, SARS and MERS. Literature analysis showed that SARS-CoV, MERS-CoV and SARS-CoV-2 infections seem to affect children less commonly and less severely as compared with adults. Since children are usually asymptomatic, they are often not tested, leading to an underestimate of the true numbers infected. Most of the documented infections belong to family clusters, so the importance of children in transmitting the virus remains uncertain. Like in SARS and MERS infection, there is the possibility that children are not an important reservoir for novel CoVs and this may have important implications for school attendance. While waiting for an effective against SARS-CoV-2, further prevalence studies in paediatric age are needed, in order to clarify the role of children in different age groups in the spread of the infection.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article

Figures

Figure 1.
Figure 1.
Classification of different types of human coronaviruses within the family Coronaviridae, subfamily Orthocoronavirinae, and the respective genera: alpha-, beta-, gamma-, and deltacoronaviruses
Figure 2.
Figure 2.
Confirmed COVID-19 cases at pediatric age (0-18), adapted from Istituto Superiore di Sanità (69)
Figure 3.
Figure 3.
Distribution in group ages, adapted from Istituto Superiore di Sanità (69)
Figure 4.
Figure 4.
Female versus male pediatric cases in different age groups, adapted from Istituto Superiore di Sanità (69)
See this image and copyright information in PMC

References

    1. Lai MM. Coronavirus: organization, replication and expression of genome. Annu Rev Microbiol. 1990;44:303–333. doi:10.1146/annurev.mi.44.100190.001511. - PubMed
    1. Masters PS, Perlman S, et al. Coronaviridae. In: Knipe DM, Howley PM, Cohen JI, editors. Fields Virology. 6th ed. Vol. 2. Philadelphia: Lippincott Williams & Wilkins, a Wolters Kluwer business; 2013. p. 825.
    1. Woo PC, Huang Y, Lau SK, Yuen KY. Coronavirus genomics and bioinformatics analysis. Viruses. 2010;2(8):1804–1820. doi:10.3390/v2081803. - PMC - PubMed
    1. James Maclachlan N, Edward J Dubovi. Fenner’s Veterinary Virology. 2017 Chapter 24, p. 435.
    1. Su S, Wong G, Shi W, et al. Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses. Trends Microbiol. 2016;24(6):490–502. doi:10.1016/j.tim.2016.03.003. - PMC - PubMed