Coronavirus disease 2019 (COVID-19) in children and/or adolescents: a meta-analysis

Background To assess the overall prevalence of clinical signs, symptoms, and radiological findings in children and/or adolescents with COVID-19. Methods We systematically researched in PubMed, Scopus and Web of Science databases observational studies describing COVID-19 in children and/or adolescents until April 11, 2020. Data regarding clinical and radiological features were extracted from eligible studies and meta-analysis was performed using random-effects modeling. Results We examined 19 eligible studies for a total of 2855 children and/or adolescents with COVID-19. Approximately 47% of subjects had fever (95% confidence interval [CI] 22-72%;I-2 = 98.6%), 37% cough (95%CI 15-63%;I-2 = 98.6%), 4% diarrhea (95%CI 0-12%;I-2 = 92.2%), 2% nasal congestion (95%CI 0-7%;I-2 = 87.7%), 1% dyspnea (95%CI 0-7%;I-2 = 91.5%) and 0% abdominal pain (95%CI 0-1%;I-2 = 76.3%). Subjects presented mild symptoms in 79% (95%CI 65-91%;I-2 = 93.5%) of cases, whereas only 4% (95%CI 1-9%;I-2 = 76.4%) were critical. Among those with pneumonia on computed tomography, 26.4% (95%CI 13-41%;I-2 = 80.8%) presented a unilateral involvement, 16% (95%CI 5-29%,I-2 = 81.2%) had bilateral involvement and 9% (95%CI 0-24%;I-2 = 88.7%) had interstitial pneumonia. Conclusions Children and/or adolescents tend to have a mild COVID-19 course with a good prognosis. Impact Compared to adults, children and/or adolescents tend to have a mild COVID-19 course with a good prognosis. This study provides new and consistence information on the clinical and radiological characteristics of COVID-19 in pediatrics. This study may help to fight COVID-19 in pediatric population.

Automated summary

This study systematically evaluated the clinical signs and radiological findings of children and adolescents with COVID-19, finding that they tend to present with mild symptoms and have a good prognosis. Specific symptoms include fever, cough, and pneumonia on imaging.