COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings

Mansurian, M.; Ghandi, Y.; Habibi, D.; Mehrabi, S.

Objective: We aimed to provide a meta-analysis of previously published papers on the COVID-19-related clinical features and laboratory findings in children. Method: This meta-analysis was conducted by using Medline/PubMed, Scopus, Web of Sciences and Google Scholar. Finally, 32 articles were selected for full-text assessment. Results: The most frequent symptoms were fever, cough, vomiting, diarrhea, sore throat, and dyspnea. Regarding the combined results of the meta-analysis, fever (46%, 95% CI 40–53%), cough (37%, 95% CI 29–46%), diarrhea (19%, 95% CI 9–28%), and pharyngalgia (13%, 95% CI 5–20%) were the most widely reported symptom. Besides, positive RT-PCR test results (43%, 95% CI 33–53%), low oxygen saturation (38%, 95% CI 25–51%), and elevated D-dimer levels (36%, 95% CI 16–56%) were the most common laboratory findings. Conclusion: This review found that clinical presentations were milder, the prognosis was better, and the mortality rate was lower in children with COVID-19 compared with adult patients; however, children are potential carriers, like adults, and can transmit the infection among the population. Therefore, early identification and intervention in pediatric patients with COVID-19 are essential in order to control the pandemic. Moreover, gastrointestinal symptoms were more common symptoms among children.