SARS-CoV-2 (COVID-19): What do we know about children? A systematic review

Author(s): Nisha S Mehta , MA (Oxon), MBBS, MRCPsych, MRCGP ¹ , Oliver T Mytton , BM, BCh, MA, MRCP, MPH, MFPH, PhD ² , Edward W S Mullins , PhD, MRCOG ³ ^, ⁴ , Tom A Fowler , FFPH, PhD, MPH ⁵ , Catherine L Falconer , MSc, MPH, PhD, MFPH ⁶ , Orla B Murphy ⁷ , Claudia Langenberg , Dr med, MSc, PhD, FFPH ⁸ ^, ⁹ ^, ¹⁰ , Wikum J P Jayatunga , MBBS, BSc, MSc, MFPH ¹¹ , Danielle H Eddy , MRCPCH, MBBCh, BSc, PGCert ¹² , Jonathan S Nguyen-Van-Tam , MBE, BMedSci, BMBS, DM, FFPH, FRCPath, FRSB, FRSPH, Hon FFPM ¹³ ^, ¹⁴

Publication date (Electronic): 11 May 2020

Journal: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

Publisher: Oxford University Press

Keywords: coronavirus, SARS-CoV-2, COVID-19, children, infection, transmission

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Abstract

BACKGROUND

Few paediatric cases of COVID-19 have been reported and we know little about the epidemiology in children, though more is known about other coronaviruses. We aimed to understand the infection rate, clinical presentation, clinical outcomes and transmission dynamics for SARS-CoV-2, in order to inform clinical and public health measures.

METHODS

We undertook a rapid systematic review and narrative synthesis of all literature relating to SARS-CoV-2 in paediatric populations. The search terms also included SARS-CoV and MERS-CoV. We searched three databases and the COVID-19 resource centres of eleven major journals and publishers. English abstracts of Chinese language papers were included. Data were extracted and narrative syntheses conducted.

RESULTS

24 studies relating to COVID-19 were included in the review. Children appear to be less affected by COVID-19 than adults by observed rate of cases in large epidemiological studies. Limited data on attack rate indicate that children are just as susceptible to infection. Data on clinical outcomes are scarce but include several reports of asymptomatic infection and a milder course of disease in young children, though radiological abnormalities are noted. Severe cases are not reported in detail and there are little data relating to transmission.

CONCLUSIONS

Children appear to have a low observed case rate of COVID-19 but may have similar rates to adults of infection with SARS-CoV-2. This discrepancy may be because children are asymptomatic or too mildly infected to draw medical attention, be tested and counted in observed cases of COVID-19.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Infect Dis

Journal ID (iso-abbrev): Clin. Infect. Dis

Journal ID (publisher-id): cid

Title: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

Publisher: Oxford University Press (US )

ISSN (Print): 1058-4838

ISSN (Electronic): 1537-6591

Publication date (Electronic): 11 May 2020

Electronic Location Identifier: ciaa556

Affiliations

[1 ] Clinical Advisor to the Chief Medical Officer (England), Department of Health and Social Care (England), London, UK

[2 ] NIHR Academic Clinical Lecturer, University of Cambridge, Cambridge, UK

[3 ] Clinical Advisor to the Chief Medical Officer (England), NIHR Academic Clinical Lecturer, Imperial College London, London, UK

[4 ] Post-CCT, Obstetrics and Gynaecology, Queen Charlotte’s and Chelsea Hospital, London, UK

[5 ] Deputy Chief Scientist, Genomics England, London, UK

[6 ] Acting Consultant in Public Health, Somerset County Council, Taunton, UK

[7 ] Chief Medical Officer’s Independent Annual Reports Manager (England), Department of Health and Social Care (England), London, UK

[8 ] Programme Lead, MRC Epidemiology Unit, University of Cambridge, Cambridge UK

[9 ] Hon Consultant Physician, Public Health England, London, UK

[10 ] Clinician in Residence, The Francis Crick Institute, London, UK

[11 ] Public Health Registrar to the Chief Medical Officer (England), Department of Health and Social Care (England), London, UK

[12 ] National Clinical Director’s Fellow, Public Health England, London, UK

[13 ] Deputy Chief Medical Officer, Department of Health and Social Care (England), London, UK

[14 ] Professor of Health Protection, University of Nottingham School of Medicine, Nottingham UK

Author notes

Corresponding author: Nisha Mehta, Department of Health and Social Care, 39 Victoria Street, London, SW1H 0EU, UK Email: nisha.mehta@ 123456dhsc.gov.uk

Article

Publisher ID: ciaa556

DOI: 10.1093/cid/ciaa556

PMC ID: 7239259

PubMed ID: 32392337

SO-VID: 7fc70011-0617-4c15-a4f7-93b860cfb10d

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