Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults.
Level 4 - case-series / case-control
Systematic review of early observational case series, case reports, and letters
PubMed 32202343 · doi:10.1111/apa.15270
What was done
Authors conducted a systematic review searching MEDLINE and Embase from January 1 to March 18, 2020, to identify studies and reports describing COVID-19 symptoms, diagnosis, transmission, and prognosis in children.
What was found
The search identified 45 relevant scientific papers and letters. Children accounted for 1% to 5% of diagnosed COVID-19 cases. They presented primarily with fever and respiratory symptoms but rarely developed severe pneumonia. Elevated inflammatory markers were less common than in adults, lymphocytopenia was rare, and deaths were extremely rare. Newborns developed symptomatic disease, though evidence for vertical intrauterine transmission was scarce.
Why it matters
This review summarized the earliest pandemic evidence establishing that SARS-CoV-2 infection in children typically follows a milder clinical course with far lower mortality than in adults.
Limits
The included literature consisted entirely of early case series, case reports, and letters published during the initial 2.5 months of the pandemic. Mild or asymptomatic community infections were likely undercounted due to early testing constraints, and no pooled quantitative meta-analysis was reported in the abstract.
Cited by
- supports A meta-analysis of 45 published studies found children accounted for 1% to 5% of diagnosed COVID-19 cases as of March 18, 2020.