Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data
Background There are sparse patient-level data available for children with novel coronavirus disease (COVID-19). Therefore, there is an urgent need for an updated systematic literature review that analyzes individual children rather than aggregated data in broad age groups. Methods Six databases (ME...
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| Veröffentlicht in: | Pediatric research 2022-02, Vol.91 (3), p.494-501 |
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| creator | Christophers, Briana Gallo Marin, Benjamin Oliva, Rocío Powell, Weston T. Savage, Timothy J. Michelow, Ian C. |
| description | Background
There are sparse patient-level data available for children with novel coronavirus disease (COVID-19). Therefore, there is an urgent need for an updated systematic literature review that analyzes individual children rather than aggregated data in broad age groups.
Methods
Six databases (MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, medRxiv) were searched for studies indexed from January 1 to May 15, 2020, with MeSH terms: children, pediatrics, COVID-19, SARS-CoV-2. 1241 records were identified, of which only unique papers in English with individual patient information and documented COVID-19 testing were included. This review of 22 eligible studies followed Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data guidelines.
Results
A total of 123 patients from five countries were identified. 46% were females. The median age was 5 years (IQR = 8). At presentation, 62% had a fever, 32% had a cough, 58% had a single symptom, and 21% were asymptomatic. Abnormal chest imaging was seen in 62% (65/105) of imaged and 76.9% (20/26) of asymptomatic children. A minority of children had elevated platelets, CRP, lactate dehydrogenase, and
d
-dimer.
Conclusion
Data from this independent participant data systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
Impact
This systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
By using an independent participant data approach, this analysis underscores the challenge of diagnosing COVID-19 in pediatric patients due to the wide variety of symptoms and seemingly poor correlation of imaging findings with symptomatic disease.
The data presented from individual patients from case series or cohort studies add more granularity to the current description of pediatric COVID-19. |
| doi_str_mv | 10.1038/s41390-020-01161-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7965792</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2444384981</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-8508b60447e89b1773e84fde6468732ae9c01ceba0713ca72d6e00959b68a48d3</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS1ERYfCH2CBLLFhE_ArfrBAQsOrUqVuWraWY9_puEqcwU6m6r_HYUqBLrqwLPt899hHB6FXlLyjhOv3RVBuSENYXZRK2vAnaEVbXo9CqKdoRQivl8boY_S8lGtCqGi1eIaOOTOCMS1XaLjIkELBMWHfxxS96_EuQ4E0uSmOCY8b7LexDxXDN3Ha4vX5j9PPDTUfsMPltkwwVNDjDPsINwseU4j7GObFyeWqxZ1LEw5uci_Q0cb1BV7e7Sfo8uuXi_X35uz82-n601njhRJTo1uiO7mEAG06qhQHLTYBpJBacebAeEI9dI4oyr1TLEggxLSmk9oJHfgJ-njw3c3dAMHXNNn1dpfj4PKtHV20_yspbu3VuLfKyFYZVg3e3hnk8ecMZbJDLB763iUY52KZEIJrYTSt6JsH6PU451TjWSa5WuyoqRQ7UD6PpWTY3H-GEru0aQ9t2tqm_d2m5XXo9b8x7kf-1FcBfgBKldIV5L9vP2L7C2prqxI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2637579219</pqid></control><display><type>article</type><title>Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Christophers, Briana ; Gallo Marin, Benjamin ; Oliva, Rocío ; Powell, Weston T. ; Savage, Timothy J. ; Michelow, Ian C.</creator><creatorcontrib>Christophers, Briana ; Gallo Marin, Benjamin ; Oliva, Rocío ; Powell, Weston T. ; Savage, Timothy J. ; Michelow, Ian C.</creatorcontrib><description>Background
There are sparse patient-level data available for children with novel coronavirus disease (COVID-19). Therefore, there is an urgent need for an updated systematic literature review that analyzes individual children rather than aggregated data in broad age groups.
Methods
Six databases (MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, medRxiv) were searched for studies indexed from January 1 to May 15, 2020, with MeSH terms: children, pediatrics, COVID-19, SARS-CoV-2. 1241 records were identified, of which only unique papers in English with individual patient information and documented COVID-19 testing were included. This review of 22 eligible studies followed Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data guidelines.
Results
A total of 123 patients from five countries were identified. 46% were females. The median age was 5 years (IQR = 8). At presentation, 62% had a fever, 32% had a cough, 58% had a single symptom, and 21% were asymptomatic. Abnormal chest imaging was seen in 62% (65/105) of imaged and 76.9% (20/26) of asymptomatic children. A minority of children had elevated platelets, CRP, lactate dehydrogenase, and
d
-dimer.
Conclusion
Data from this independent participant data systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
Impact
This systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
By using an independent participant data approach, this analysis underscores the challenge of diagnosing COVID-19 in pediatric patients due to the wide variety of symptoms and seemingly poor correlation of imaging findings with symptomatic disease.
The data presented from individual patients from case series or cohort studies add more granularity to the current description of pediatric COVID-19.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-020-01161-3</identifier><identifier>PMID: 32942286</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Adolescent ; Asymptomatic ; Child ; Child, Preschool ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 diagnostic tests ; COVID-19 Testing - methods ; COVID-19 Testing - statistics & numerical data ; Databases, Factual - statistics & numerical data ; Female ; Humans ; Infant ; Male ; Medicine ; Medicine & Public Health ; Pandemics - statistics & numerical data ; Patients ; Pediatric Surgery ; Pediatrics ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Systematic Review ; Systemic Inflammatory Response Syndrome - diagnosis ; Systemic Inflammatory Response Syndrome - epidemiology</subject><ispartof>Pediatric research, 2022-02, Vol.91 (3), p.494-501</ispartof><rights>International Pediatric Research Foundation, Inc 2020</rights><rights>2020. International Pediatric Research Foundation, Inc.</rights><rights>International Pediatric Research Foundation, Inc 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-8508b60447e89b1773e84fde6468732ae9c01ceba0713ca72d6e00959b68a48d3</citedby><cites>FETCH-LOGICAL-c474t-8508b60447e89b1773e84fde6468732ae9c01ceba0713ca72d6e00959b68a48d3</cites><orcidid>0000-0001-5248-069X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-020-01161-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-020-01161-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32942286$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Christophers, Briana</creatorcontrib><creatorcontrib>Gallo Marin, Benjamin</creatorcontrib><creatorcontrib>Oliva, Rocío</creatorcontrib><creatorcontrib>Powell, Weston T.</creatorcontrib><creatorcontrib>Savage, Timothy J.</creatorcontrib><creatorcontrib>Michelow, Ian C.</creatorcontrib><title>Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Background
There are sparse patient-level data available for children with novel coronavirus disease (COVID-19). Therefore, there is an urgent need for an updated systematic literature review that analyzes individual children rather than aggregated data in broad age groups.
Methods
Six databases (MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, medRxiv) were searched for studies indexed from January 1 to May 15, 2020, with MeSH terms: children, pediatrics, COVID-19, SARS-CoV-2. 1241 records were identified, of which only unique papers in English with individual patient information and documented COVID-19 testing were included. This review of 22 eligible studies followed Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data guidelines.
Results
A total of 123 patients from five countries were identified. 46% were females. The median age was 5 years (IQR = 8). At presentation, 62% had a fever, 32% had a cough, 58% had a single symptom, and 21% were asymptomatic. Abnormal chest imaging was seen in 62% (65/105) of imaged and 76.9% (20/26) of asymptomatic children. A minority of children had elevated platelets, CRP, lactate dehydrogenase, and
d
-dimer.
Conclusion
Data from this independent participant data systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
Impact
This systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
By using an independent participant data approach, this analysis underscores the challenge of diagnosing COVID-19 in pediatric patients due to the wide variety of symptoms and seemingly poor correlation of imaging findings with symptomatic disease.
The data presented from individual patients from case series or cohort studies add more granularity to the current description of pediatric COVID-19.</description><subject>Adolescent</subject><subject>Asymptomatic</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 diagnostic tests</subject><subject>COVID-19 Testing - methods</subject><subject>COVID-19 Testing - statistics & numerical data</subject><subject>Databases, Factual - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pandemics - statistics & numerical data</subject><subject>Patients</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Systematic Review</subject><subject>Systemic Inflammatory Response Syndrome - diagnosis</subject><subject>Systemic Inflammatory Response Syndrome - epidemiology</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtv1DAUhS1ERYfCH2CBLLFhE_ArfrBAQsOrUqVuWraWY9_puEqcwU6m6r_HYUqBLrqwLPt899hHB6FXlLyjhOv3RVBuSENYXZRK2vAnaEVbXo9CqKdoRQivl8boY_S8lGtCqGi1eIaOOTOCMS1XaLjIkELBMWHfxxS96_EuQ4E0uSmOCY8b7LexDxXDN3Ha4vX5j9PPDTUfsMPltkwwVNDjDPsINwseU4j7GObFyeWqxZ1LEw5uci_Q0cb1BV7e7Sfo8uuXi_X35uz82-n601njhRJTo1uiO7mEAG06qhQHLTYBpJBacebAeEI9dI4oyr1TLEggxLSmk9oJHfgJ-njw3c3dAMHXNNn1dpfj4PKtHV20_yspbu3VuLfKyFYZVg3e3hnk8ecMZbJDLB763iUY52KZEIJrYTSt6JsH6PU451TjWSa5WuyoqRQ7UD6PpWTY3H-GEru0aQ9t2tqm_d2m5XXo9b8x7kf-1FcBfgBKldIV5L9vP2L7C2prqxI</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Christophers, Briana</creator><creator>Gallo Marin, Benjamin</creator><creator>Oliva, Rocío</creator><creator>Powell, Weston T.</creator><creator>Savage, Timothy J.</creator><creator>Michelow, Ian C.</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5248-069X</orcidid></search><sort><creationdate>20220201</creationdate><title>Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data</title><author>Christophers, Briana ; Gallo Marin, Benjamin ; Oliva, Rocío ; Powell, Weston T. ; Savage, Timothy J. ; Michelow, Ian C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-8508b60447e89b1773e84fde6468732ae9c01ceba0713ca72d6e00959b68a48d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Asymptomatic</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 diagnostic tests</topic><topic>COVID-19 Testing - methods</topic><topic>COVID-19 Testing - statistics & numerical data</topic><topic>Databases, Factual - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pandemics - statistics & numerical data</topic><topic>Patients</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Systematic Review</topic><topic>Systemic Inflammatory Response Syndrome - diagnosis</topic><topic>Systemic Inflammatory Response Syndrome - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Christophers, Briana</creatorcontrib><creatorcontrib>Gallo Marin, Benjamin</creatorcontrib><creatorcontrib>Oliva, Rocío</creatorcontrib><creatorcontrib>Powell, Weston T.</creatorcontrib><creatorcontrib>Savage, Timothy J.</creatorcontrib><creatorcontrib>Michelow, Ian C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Christophers, Briana</au><au>Gallo Marin, Benjamin</au><au>Oliva, Rocío</au><au>Powell, Weston T.</au><au>Savage, Timothy J.</au><au>Michelow, Ian C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>91</volume><issue>3</issue><spage>494</spage><epage>501</epage><pages>494-501</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background
There are sparse patient-level data available for children with novel coronavirus disease (COVID-19). Therefore, there is an urgent need for an updated systematic literature review that analyzes individual children rather than aggregated data in broad age groups.
Methods
Six databases (MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, medRxiv) were searched for studies indexed from January 1 to May 15, 2020, with MeSH terms: children, pediatrics, COVID-19, SARS-CoV-2. 1241 records were identified, of which only unique papers in English with individual patient information and documented COVID-19 testing were included. This review of 22 eligible studies followed Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data guidelines.
Results
A total of 123 patients from five countries were identified. 46% were females. The median age was 5 years (IQR = 8). At presentation, 62% had a fever, 32% had a cough, 58% had a single symptom, and 21% were asymptomatic. Abnormal chest imaging was seen in 62% (65/105) of imaged and 76.9% (20/26) of asymptomatic children. A minority of children had elevated platelets, CRP, lactate dehydrogenase, and
d
-dimer.
Conclusion
Data from this independent participant data systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
Impact
This systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom.
By using an independent participant data approach, this analysis underscores the challenge of diagnosing COVID-19 in pediatric patients due to the wide variety of symptoms and seemingly poor correlation of imaging findings with symptomatic disease.
The data presented from individual patients from case series or cohort studies add more granularity to the current description of pediatric COVID-19.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>32942286</pmid><doi>10.1038/s41390-020-01161-3</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5248-069X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adolescent Asymptomatic Child Child, Preschool Coronaviruses COVID-19 COVID-19 - complications COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 diagnostic tests COVID-19 Testing - methods COVID-19 Testing - statistics & numerical data Databases, Factual - statistics & numerical data Female Humans Infant Male Medicine Medicine & Public Health Pandemics - statistics & numerical data Patients Pediatric Surgery Pediatrics SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Systematic Review Systemic Inflammatory Response Syndrome - diagnosis Systemic Inflammatory Response Syndrome - epidemiology |
| title | Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data |
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