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COVID-19 under 19: A Meta-analysis
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  • Nagham Toba,
  • Shreya Gupta,
  • Abdulrahman Ali,
  • Mariam ElSaban,
  • Amar HK,
  • Samuel Ho,
  • Rizwana Popatia
Nagham Toba
Mohammed Bin Rashid University of Medicine and Health Sciences College of Medicine
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Shreya Gupta
Mohammed Bin Rashid University of Medicine and Health Sciences
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Abdulrahman Ali
Mohammed Bin Rashid University of Medicine and Health Sciences
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Mariam ElSaban
Mohammed Bin Rashid University of Medicine and Health Sciences Hamdan Bin Mohammed College of Dental Medicine
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Amar HK
Mohammed Bin Rashid University of Medicine and Health Sciences
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Samuel Ho
Mohammed Bin Rashid University of Medicine and Health Sciences
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Rizwana Popatia
Mohammed Bin Rashid University of Medicine and Health Sciences
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Abstract

Background: The COVID-19 pandemic has caused a global havoc with our limited understanding of the SARS-CoV-2, disease manifestations and management. Inadequacy of available data in pediatric patients coupled with evolving disease course makes it imperative to conduct a meta-analysis assessing the results of pediatric COVID-19 studies over the course of the pandemic. Methods: A random-effect meta-analysis was conducted using PRISMA guidelines. Two databases were screened for pediatric COVID-19 studies and selected articles reviewed for demographic, co-morbidities, clinical manifestations, laboratory and radiological evaluation, treatment and outcomes. Prevalence with mean and 95% confidence interval was calculated. Results: Out of 1703 articles, 37 articles comprising of 993 patients for a period of over six months and 72 variables were selected. This meta-analysis revealed that one-fourth of patients were asymptomatic (23.8%, 95% CI 17.6-31.2%) Fever (52.5%, 95% CI 45.7–59.1%) and cough (47.6%, 95% CI 41.2–54.0%) were the most common symptoms. The most frequently encountered white blood count abnormalities were neutropenia (16.6%, 95% CI 10.2-25.8%), lymphocytosis (15.3%, 95% CI 9.9–23.0%) and leukopenia (13.9%, 95% CI 10.1–18.8%). Ground glass opacities were the most common radiological finding of children with COVID-19 (35.9%, 95% CI 29.4-43%).  The hospitalization rate was 95.9% (95% CI 91.9-98.0%) of which 11.2% (95% CI 4.7-24.2) were ICU admissions, and 4.2% (95% CI 2.6-6.9%) died. Conclusion: Majority of pediatric patients are asymptomatic or have mild manifestations similar to other upper respiratory viruses. Serious disease and death occurred in 15.4%. More studies are needed from a wider geographic area as the pandemic continues.

Peer review status:UNDER REVIEW

18 Aug 2020Submitted to Pediatric Pulmonology
20 Aug 2020Assigned to Editor
20 Aug 2020Submission Checks Completed
17 Sep 2020Reviewer(s) Assigned