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Mehta NS, Mytton OT, Mullins EWS, Fowler TA, Falconer CL, Murphy OB, Langenberg C, Jayatunga WJP, Eddy DH, Nguyen-Van-Tam JS. SARS-CoV-2 (COVID-19): What Do We Know About Children? A Systematic Review. Clin Infect Dis 2020; 71:2469-2479. [PMID: 32392337 PMCID: PMC7239259 DOI: 10.1093/cid/ciaa556] [Citation(s) in RCA: 258] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/13/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Few pediatric cases of coronavirus disease 2019 (COVID-19) have been reported and we know little about the epidemiology in children, although more is known about other coronaviruses. We aimed to understand the infection rate, clinical presentation, clinical outcomes, and transmission dynamics for severe acute respiratory syndrome coronavirus 2 (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 pediatric populations. The search terms also included SARS-CoV and MERS-CoV. We searched 3 databases and the COVID-19 resource centers of 11 major journals and publishers. English abstracts of Chinese-language papers were included. Data were extracted and narrative syntheses conducted. RESULTS Twenty-four 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, although radiological abnormalities are noted. Severe cases are not reported in detail and there are few data relating to transmission. CONCLUSIONS Children appear to have a low observed case rate of COVID-19 but may have rates similar to adults of infection with SARS-CoV-2. This discrepancy may be because children are asymptomatic or too mildly infected to draw medical attention and be tested and counted in observed cases of COVID-19.
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Affiliation(s)
- Nisha S Mehta
- Department of Health and Social Care (England), London, United Kingdom
| | | | - Edward W S Mullins
- Imperial College London, London, United Kingdom
- Obstetrics and Gynecology, Queen Charlotte’s and Chelsea Hospital, London, United Kingdom
| | | | | | - Orla B Murphy
- Department of Health and Social Care (England), London, United Kingdom
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Public Health England, London, United Kingdom
- The Francis Crick Institute, London, United Kingdom
| | | | | | - Jonathan S Nguyen-Van-Tam
- Department of Health and Social Care (England), London, United Kingdom
- University of Nottingham School of Medicine, Nottingham, United Kingdom
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Chaves A, Ibarra-Cerdeña CN, López-Pérez AM, Monge O, Avendaño R, Ureña-Saborio H, Chavarría M, Zaldaña K, Sánchez L, Ortíz-Malavassi E, Suzan G, Foley J, Gutiérrez-Espeleta GA. Bocaparvovirus, Erythroparvovirus and Tetraparvovirus in New World Primates from Central America. Transbound Emerg Dis 2019; 67:377-387. [PMID: 31529612 DOI: 10.1111/tbed.13357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 09/02/2019] [Accepted: 09/07/2019] [Indexed: 12/20/2022]
Abstract
Parvoviruses in the genera Bocaparvovirus (HBoV), Erythroparvovirus (B19) and Tetraparvovirus (PARV4) are the only autonomous parvoviruses known to be associated with human and non-human primates based on studies and clinical cases in humans worldwide and non-human primates in Asia and Africa. Here, the presence of these agents with pathogenic potential was assessed by PCR in blood and faeces from 55 howler monkeys, 112 white-face monkeys, 3 squirrel monkeys and 127 spider monkeys in Costa Rica and El Salvador. Overall, 3.7% (11/297) of the monkeys had HboV DNA, 0.67% (2/297) had B19 DNA, and 14.1% (42/297) had PARV4 DNA, representing the first detection of these viruses in New World Primates (NWP). Sex was significantly associated with the presence of HBoV, males having greater risk up to nine times compared with females. Captivity was associated with increased prevalence for PARV4 and when all viruses were analysed together. This study provides compelling molecular evidence of parvoviruses in NWPs and underscores the importance of future research aimed at understanding how these viruses behave in natural environments of the Neotropics and what variables may favour their presence and transmission.
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Affiliation(s)
- Andrea Chaves
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA.,Escuela de Biología, Universidad de Costa Rica, San José, Costa Rica
| | - Carlos N Ibarra-Cerdeña
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del IPN (Cinvestav), Unidad Mérida, Mérida, México
| | - Andrés M López-Pérez
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA.,Departamento de Etología, Fauna Silvestre y Animales de Laboratorio, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, México D.F, México
| | - Otto Monge
- Escuela de Biología, Universidad de Costa Rica, San José, Costa Rica
| | - Roberto Avendaño
- Centro Nacional de Innovaciones Biotecnológicas (CENIBiot), CeNAT-CONARE, San José, Costa Rica
| | - Hilary Ureña-Saborio
- Centro Nacional de Innovaciones Biotecnológicas (CENIBiot), CeNAT-CONARE, San José, Costa Rica
| | - Max Chavarría
- Centro Nacional de Innovaciones Biotecnológicas (CENIBiot), CeNAT-CONARE, San José, Costa Rica.,Escuela de Química & CIPRONA, Universidad de Costa Rica, San José, Costa Rica
| | - Karla Zaldaña
- Asociación Territorios Vivos El Salvador, San Salvador, El Salvador
| | - Lucía Sánchez
- Asociación Territorios Vivos El Salvador, San Salvador, El Salvador
| | - Edgar Ortíz-Malavassi
- Escuela de Ingienería Forestal, Instituto Tecnológico de Costa Rica, Cartago, Costa Rica
| | - Gerardo Suzan
- Departamento de Etología, Fauna Silvestre y Animales de Laboratorio, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, México D.F, México
| | - Janet Foley
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
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