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The COVID-19 pandemic in a paediatric population: A health care perspective Cover

The COVID-19 pandemic in a paediatric population: A health care perspective

By: Viral P. Maru and  Salil Bapat  
Open Access
|Apr 2022

Figures & Tables

Figure 1

Evolution of Coronaviruses.
Evolution of Coronaviruses.

Figure 2

PRISMA flow diagram.
PRISMA flow diagram.

Figure 3

Quality assessment of case reports.
Quality assessment of case reports.

Figure 4

Quality assessment of case series.
Quality assessment of case series.

Figure 5

Quality assessment of cross-sectional studies.
Quality assessment of cross-sectional studies.

Figure 6

Proposed flow chart for management of children with COVID-19 like symptoms.
Proposed flow chart for management of children with COVID-19 like symptoms.

Figure 7

Proposed flow chart for management and supervision of COVID-19 positive children.
Proposed flow chart for management and supervision of COVID-19 positive children.

Figure 8

Continuum of COVID-19 in children.
Continuum of COVID-19 in children.

Characteristics of the studies included_

Sl No.Author’s nameTitle of studyType of studyPurpose of studyResults of study
1.Chuming C et al.23Coronavirus Disease- 19 Among Children Outside Wuhan, ChinaCross- sectional. (31 children < 18 yrs.)Description of characteristic features of infection in children.12 infants (38.7%) showed remaining two-thirds had minor cases in children). The majority not have any underlying illnesses had underlying diseases, one and the other had duplicate the children were in familial
2.Feng K et al.24Analysis of CT features of 15 Children with coronavirus 2019 novel infection.Cross sectional. (15 children of age 4–14 yrs.)To study computed tomography features in children with COVID-19.For their first chest CT images, lesions, while 9 patients had lesions. Seven cases of small opacities and 2 cases of opacities were found.
3.Pan X et al.25Asymptomatic cases in a family cluster with SARS-CoV-2 infectionCase series.Case study of clinical characteristics family cluster of COVID-19 (mother, 33; father, 35; 3-year-old boy).▪ Clinical Manifestation: asymptomatic.
4.Sun K et al.26Early epidemiological analysis of the coronavirus disease 2019 outbreak based on crowdsourced data: a population-level observational study.Cross- sectional study. (9,507 children under the age of 15 yrs.)A population-level research analysis is being conducted using data from a health care-oriented social network that is currently▪ Clinical manifestation: no
broadcasting COVID-19 news stories from local and national Chinese health authorities and agencies with regards to COVID-19 epidemiology patterns, including the spread of the epidemic in China.
5.Wang P et al.27Epidemiological characteristics of 1212 COVID-19 patients in Henan, ChinaCross- sectional study.Cross-sectional analysis publicly of available data.Out of 1,212 COVID-19 cases aged 0–10 years (1.98%) and 21 cases aged
6.Henry BM et al.28Preliminary epidemiological analysis on children and adolescents with novel coronavirus disease 2019 outside Hubei Province, China: an observational study utilizing crowdsourced dataCross- sectional study. (children < 19 yrs) 53 children (0–12 yrs) and 27 adolescents (13–19 yrs).To study crowdsourced data outside of Hubei province (i.e., includes mainland China minus Hubei and rest of the world).Fever was the most common followed by cough (36%). asymptomatic. A total of 29 noted to have an infected family.
7.Yu H et al.29Data-driven discovery of clinical routes for severity detection of COVID-19 paediatric casesCross- sectional study.To assess 105 cases of COVID-19 infected children diagnosed in Wuhan. 64 males, 41 females.Shortness of breath, supported respiration, apnea, cyanosis, dehydration, and progressive increase of lactate were reported. 8 were critically ill.
8.Tank A et al.30A retrospective study of the clinical characteristics of COVID-19 infection in 26 children.Case series.To assess clinical features in children with COVID-19.▪ 9 patients were asymptomatic. Fever was the most common symptom. Other symptoms, cough (in eleven of seventeen patients), rhinorrhea (in two), diarrhea (in two), vomiting (in two), were also observed. A small minority of patients had lymphocytopenia.

▪ According to chest CT scan, 11 patients showed unilateral pneumonia, 8 patients had no pulmonary infiltration.

9.Li-Na Ji et al.31two family clusters features in▪ Mild respiratory or gastrointestinal
cases.Case series.children COVID-19. withBoth of them had normal ▪
(2 children)▪ After general and symptomatic children recovered quickly.
10.Park JY et al.32First Paediatric Case of Coronavirus Disease 2019 in Korea.Case report. (10 yr old girl)Reporting the features of first paediatric patient with COVID-19 in Korea.The girl reported with low computed tomography (CT) nodular consolidations with opacities in subpleural areas She recovered without any
Rahimzadeh Reporting▪ All children had at least one
11.G et al.33COVID-19 infection in Iranian Children: ACase series.features of▪ Fever, chills, myalgia, cough, and crackle were common
case series of 9 patients.(9 children with age 2–COVID-19 in Iranian children.patients presented with diarrhea, nose. Three cases had leukopenia
10 yrs).All cases received supportive therapy.
12Xia W et al.34Clinical and CT features in paediatric patients with COVID‐ 19 infection: Different points from adultsCross- sectional study.Case series of 20 paediatric patients from Wuhan Children's Hospital who presented from January 23 to February 8, 2020, with the primary goal of describing radiological characteristics.Average length of hospital confirmed by pharyngeal swab acid test. Seven of 20 had underlying (congenital). No evidence that the virus. Thirteen of 20 cases with COVID-19
13.Xu H et al.35A follow-up study of children infected with SARS-CoV-2 from Western China.Cross- sectional studyTo study the features and the duration of positive nucleic▪ 11 children (34%) were asymptomatic, whom 6 had normal computed scan images.
(32 children).acid in children with COVID-19.▪ All children recovered. No
14.Shekerdemian L et al.36Characteristics and Outcomes With Coronavirus of Children Disease 2019 (COVID- 19) Infection AdmittedCross- sectional study,To experience assess the of COVID-19 in paediatric▪ 40 children (83%) had preexisting medical conditions, 35 (73respiratory symptoms, and invasive ventilation.
to US and Canadian Paediatric Intensive Care Units.(48 children).intensive care units.▪ The hospital mortality rate
15.Dong Y et al.37Epidemiology of COVID-19 among children in ChinaCross- sectional study. (2,135To study the epidemiological and transmission▪ More than 90% of all children mild, or moderate cases. illness onset to diagnoses days).
children with mean age 7 yrs.)patterns in children with COVID-19▪ Mild 314 (43.1); Moderate (2.5); Critical 3 (0.4); Missing (0.1).
16.Qui H et al.38Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID- 19) in Zhejiang, China: an observational cohort study.Cross-sectional study. (36 children with mean age 8.3 years).To assess the clinical and epidemiological features of children with COVID-19.▪ Transmission: Through close members (32 [89%]) or a epidemic area (12 [33%]); both exposures. ▪ Clinical manifestation: 19 pneumonia; 17 (47%) had either were asymptomatic upper respiratory symptoms symptoms: fever (36%) and those with fever, four (11of 38.5°C or higher, and temperature of 37.5°–38.
▪ Management: All children by aerosolization twice a lopinavir–ritonavir syrup needed oxygen inhalation.
17.Qiu C et al.39Transmission and clinical characteristics of coronavirus disease 2019 in 104 outside- Wuhan patients, China.Cross-sectional study. (3 children)Contact investigation was conducted on each patient who was admitted to the assignedTransmission through family
hospitals in Hunan Province.
18.Wang S et al.40A Case Report of Neonatal 2019 Coronavirus Disease in China.Case report.Reporting a case of neonatal COVID-19 infection in China with pharyngeal swabs tested positive by RT-PCR assay, 36 hours after birth.The infant was isolated in hospital. x-ray showed thickened abnormalities in heart and palate.
19.Kam KQ et al41A well infant with Coronavirus Disease 2019 (COVID-19) with high viral load.Case report. (6-month-old infant).A case report highlighting the difficulties in establishing the true incidence of COVID-19.Infant was asymptomatic. Diagnosis through the presence stools of infant.
A Case Series of ▪ Eight (80%) children had patients with COVID-19 of travel to Wuhan or Wuhan.
Children With 2019 Novel Coronavirus Infection: Clinical andCase series. (10 childrenTo study clinical and epidemiological▪ For the 3-month-old infant, symptomatic COVID-19after the sick baby without
20.Cai J et al.42Epidemiological Featureswith mean 74 months of age)features in children with COVID-19.▪ The interval between symptom index symptomatic case (mean: 6.5 days) and the onset and departure from and 9 days.
▪ Eight (80%) patients had 4 (40%) had sore throat, 3 2 (20%) had sneezing and
▪ Chest radiograph revealed in 4 (40%) of 10 patients.
▪ Out of those admitted symptomatic. Fever was from chills, cough, loss shortness of breath etc.
21.Graff K et al.43Risk factors for severe COVID-19 in children.Cross- sectional study 454 children. 191 females.To describe the epidemiology and risk factors for severe COVID-19▪ 45% of children with COVID comorbid condition. The comorbid conditions identified (16.7%), gastrointestinal disease (10.6%).
Average age 11 years.disease in children.▪ Diagnosis through nasopharyngeal washes/aspirates, and bronchoalveolar and RT PCR.
▪ 55% required respiratory critical care.
COVID-19-related giant coronary aneurysms in an infant Reporting a case
22.Ghatasheh G et al.44with multisystem inflammatory disorder in children: the firstCase report (infant of 9 months ofof COVID-19 related aneurysms in an▪ The clinical and biochemical compatible with complicated disease (KD).
case report from the united arab emirates and the arab region.age)infant MID in children.▪ Treated with intravenous anticoagulation for 3 weeks.
23.Sethuraman U et al.45Multisystem inflammatory syndrome in childrenCase series.To study the clinical features of MIS in▪ Most of them were African older than 5 years old who once in the previous 48
associated with novel coronavirus SARS- children with COVID-19.▪ More than a third of the with asthma being the most
CoV-2: Presentations to a paediatric emergency department in Michigan. ▪ The most frequent signs gastrointestinal symptoms or diarrhea), anorexia, symptoms were uncommon.
Comparison of clinical ▪ Although 44.4 percent abdominal tenderness, only right lower quadrant tenderness.
and epidemiologic characteristics of young febrile infantsCrossTo evaluate and compare clinical▪ In 2020, fewer febrile infection or a positive respiratory in previous years (6 percent
Leibowitz J etwith and withoutsectional study.and epidemiological▪ respectively). COVID-19 was the most
24al.46Severe Acute(124 infantsfeatures in febrilein 2020, with 20 out of
Respiratory Syndrome Coronavirus-2 Infection.of age < 57 days).infants with or without COVID -▪ Infants infected with COVID-to register as Hispanic.
19.▪ None of the babies who substantial bacterial infection.
Severe acute respiratory syndrome coronavirus 2 clinicalCrossReview of▪ Overall, 143 (51%) had respiratory (25%) had MIS-C, and 69 manifestations including fever.
25Fernandes DM et al.47syndromes and predictors of disease severity in hospitalized children and youth.sectional study (281 paediatric patients).clinical features of 281 hospitalized kids with COVID-19.▪ Patients with MIS-C were non-Hispanic black compared respiratory disease (35% (2%) died and 114 (41%) intensive care unit.
▪ Race/ethnicity or socioeconomic predictive of disease severity.
26Simpson JN et al.48Results of testing children for severe acute respiratory syndrome coronavirus-Retrospective cross- sectional study.To study the demographics, clinical features, and test results of▪ 28.2% had a positive polymerase test.
2 through a community-based testing site.(1,445 children < 21 years of age)children with COVID-19 in community▪ The daily positivity rate increased period, from 5.4% during 47.4%.
setting.▪ Patients with fever or cough contact with someone with infection were more likely
DOI: https://doi.org/10.34763/jmotherandchild.20212502.d-21-00008 | Journal eISSN: 2719-535X | Journal ISSN: 2719-6488
Language: English
Page range: 102 - 118
Submitted on: Apr 8, 2021
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Accepted on: Jul 2, 2021
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Published on: Apr 1, 2022
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2022 Viral P. Maru, Salil Bapat, published by Institute of Mother and Child
This work is licensed under the Creative Commons Attribution 4.0 License.