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Kulkarni D, Ismail NF, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Rahman AE, Kyaw MH, Nair H. Epidemiology and clinical features of SARS-CoV-2 infection in children and adolescents in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2024; 14:05003. [PMID: 38419461 PMCID: PMC10902805 DOI: 10.7189/jogh.14.05003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Methods We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and the World Health Organization (WHO) COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a diagnosis of SARS-CoV-2 infection confirmed either by molecular or antigen tests. We used the Joanna Briggs Institute critical appraisal tools to appraise the study quality and conducted meta-analyses using the random effects model for all outcomes except for race/ethnicity as risk factors of SARS-CoV-2 infection. Results We included 237 studies, each reporting at least one of the study outcomes. Based on data from 117 studies, the pooled SARS-CoV-2 positivity rate was 9.30% (95% confidence interval (CI) = 7.15-11.73). Having a comorbidity was identified as a risk factor for SARS-CoV-2 infection (risk ratio (RR) = 1.33; 95% CI = 1.04-1.71) based on data from 49 studies. Most cases in this review presented with mild disease (n = 50; 52.47% (95% CI = 44.03-60.84)). However, 20.70% of paediatric SARS-CoV-2 infections were hospitalised (67 studies), 7.19% required oxygen support (57 studies), 4.26% required intensive care (93 studies), and 2.92% required assisted ventilation (63 studies). The case fatality ratio (n = 119) was 0.87% (95% CI = 0.54-1.28), which included in-hospital and out-of-hospital deaths. Conclusions Our data showed that children were at risk for SARS-CoV-2 infections and severe outcomes in the pre-Omicron era. These findings underscore the need for effective vaccination strategies for the paediatric population to protect against the acute and long-term sequelae of COVID-19. Registration PROSPERO: CRD42022327680.
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Affiliation(s)
- Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Fuyu Zhu
- Schol of Public Health, Nanjing Medical University, China
| | - Xin Wang
- Schol of Public Health, Nanjing Medical University, China
| | | | | | | | | | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Schol of Public Health, Nanjing Medical University, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Nemati Zargaran F, Rostamian M, Alimoradi S, Rezaeian S, Javadirad E, Chegene Lorestani R, Motamed H, Hasanpourshahlaei M, Rostami E, Ghadiri K. Clinical and laboratory characteristics of children with severe and nonsevere COVID-19 in Kermanshah, west of Iran: A retrospective study. Health Sci Rep 2023; 6:e1659. [PMID: 37920662 PMCID: PMC10618436 DOI: 10.1002/hsr2.1659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023] Open
Abstract
Background and Aims The study aimed to collect and compare clinical and laboratory findings of children with severe and nonsevere COVID-19 in Kermanshah City, located in the west of Iran. Methods The study was conducted on 500 children with COVID-19 hospitalized in Mohammad-Kermanshahi Hospital in Kermanshah City. Pediatric COVID-19 was confirmed by reverse transcription-polymerase chain reaction (RT-PCR) test using respiratory secretion samples. Medical records were reviewed and information related to demographic characteristics, underlying diseases, clinical manifestations, laboratory findings, and chest computed tomography (CT) scans were all extracted from electronic and paper records. Patients were divided into three groups according to the severity of the disease: mild, moderate, and severe. Clinical and laboratory findings were compared between the groups and the collected data were analyzed by statistical methods. Results Out of 500 patients, 286 were boys and 214 were girls. Of the patients, 321 cases were only COVID-19, while 179 patients were diagnosed as Multisystem Inflammatory Syndrome in Children (MIS-C) positive. The average age of COVID-19 patients was 3.85 ± 4.48 and of MIS-C patients was 3.1 ± 3.5. In order, fever, cough, and heart disorders were the most common symptoms in patients with COVID-19 and MIS-C, respectively. In terms of disease severity, 246 patients had mild disease, 19 patients had moderate disease, and 56 patients had severe disease. In severe patients, the average number of white blood cells (WBC) was higher, while the average number of lymphocytes was lower. Also, in these patients, the average age was lower, and most of them had respiratory distress. In mild patients, often cough, diarrhea, and vomiting were observed. Conclusion The results of our study showed that laboratory factors such as WBC count, lymphocyte count, CT findings, Respiratory distress, cough, diarrhea, and vomiting can be used to evaluate the severity of COVID-19 in children.
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Affiliation(s)
- Fatemeh Nemati Zargaran
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Mosayeb Rostamian
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Saeed Alimoradi
- Clinical Research Development Center, Taleghani and Imam Ali HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Shahab Rezaeian
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Etrat Javadirad
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi and Imam Reza HospitalsKermanshah University of Medical SciencesKermanshahIran
| | - Roya Chegene Lorestani
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Hajar Motamed
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | | | - Elham Rostami
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi and Imam Reza HospitalsKermanshah University of Medical SciencesKermanshahIran
| | - Keyghobad Ghadiri
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
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Shen B, Chen B, Li K, Cheng W, Mofatteh M, Regenhardt RW, Wellington J, Liang Z, Tang Q, Chen J, Chen Y. The Impact of COVID-19 Pandemic Lockdown on Emergency Department Visits in a Tertiary Hospital. Risk Manag Healthc Policy 2023; 16:1309-1316. [PMID: 37489232 PMCID: PMC10363383 DOI: 10.2147/rmhp.s415704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
Purpose This study aimed to highlight the impact of the COVID-19 pandemic lockdown on emergency department (ED) visits of non-COVID-19 patients in a tertiary hospital and evaluate protocol development during this period. Patients and Methods Clinical data of patients who visited the ED of Foshan Hospital of Traditional Chinese Medicine during the first-level response in Foshan, Guangdong province in 2020 (from January 23 to February 24) and the same period in 2019 and 2021 were collected. A retrospective cross-sectional analysis was performed to understand the characteristics of critically ill patients and compare the proportion of hospitalizations, deaths, and emergency ambulance calls (EACs). Results The number of patients presenting to the ED was significantly decreased, with a 37.75% reduction in 2020 (6196) compared to the same period in 2019 (9954). A rise in patient ED presentations was observed in the same period in 2021 (10,503). This decline was mostly in the 15-45 age group. In 2019, 2020, and 2021, critically ill patients treated by the ED totaled 568 (5.706%), 339 (5.495%), and 590 (5.617%), respectively. Compared to the same period in 2019 and 2021, the proportion of critically ill patients with respiratory system involvement, severe trauma, and poisoning decreased most significantly in 2020 (P<0.05). In contrast, the rates of EACs, hospitalizations, and deaths increased significantly (P<0.05). Conclusion The number of ED visits to hospitals was decreased during the 2020 lockdown, while the rates of EACs, hospitalizations, and deaths increased significantly though there were no documented COVID-19 cases. Optimizing emergency medical resources and ensuring the safety of healthcare providers and patients were essential to provide efficient emergency diagnosis and treatment during the lockdown.
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Affiliation(s)
- Bisheng Shen
- Department of Emergency Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, People’s Republic of China
| | - Baoxin Chen
- Faculty of Humanities and Social Sciences, Macao Polytechnic University, Macao, People’s Republic of China
| | - Kuangyi Li
- Department of Emergency Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, People’s Republic of China
| | - Weiyin Cheng
- Department of Clinical Nutrition, Foshan Hospital of Traditional Chinese Medicine, Foshan City, People’s Republic of China
| | - Mohammad Mofatteh
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Robert W Regenhardt
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Zhangrong Liang
- Department of Emergency Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, People’s Republic of China
| | - Qi Tang
- Department of Emergency Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, People’s Republic of China
| | - Jingli Chen
- Department of Emergency Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, People’s Republic of China
| | - Yimin Chen
- Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People’s Hospital, Foshan, People’s Republic of China
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The Age-Related Course of COVID-19 in Pediatric Patients-1405 Cases in a Single Center. J Clin Med 2022; 11:jcm11247347. [PMID: 36555963 PMCID: PMC9782360 DOI: 10.3390/jcm11247347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Since the beginning of the pandemic, many reports have pointed to age as the most important risk factor for severe COVID-19 in adults, but this relationship is less clear in children. Between March 2020 and April 2022, 1405 pediatric COVID-19 patients were included in our prospective study, which aimed to analyze the disease's characteristics in three age groups: infants, toddlers (1-5 years), and children (5-18 years). We observed male prevalence of the disease in infants and toddlers compared to female prevalence in children. Comorbidities appeared most often in children. In the first pandemic wave, the vast majority of pediatric patients were children, but later, the percentage of infant and toddler patients increased significantly. A total of 74% of hospitalized children were younger than five years. Upper respiratory tract symptoms were most common in infants and toddlers, and lower respiratory tract symptoms and gastroenterocolitis were more common in children. Neurological symptoms appeared similarly in all age groups. The activities of ALT, CK, and LDH were the most elevated in infants, along with D-dimers. The median length of hospitalization fluctuated between three and four days and was highest in infants. Severe courses were more common in adolescents.
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Tolunay O, Çelik Ü, Arslan I, Tutun B, Özkaya M. Evaluation of Clinical Findings and Treatment Results of Coronavirus Disease 2019 (COVID-19) in Pediatric Cancer Patients: A Single Center Experience. Front Pediatr 2022; 10:848379. [PMID: 35359885 PMCID: PMC8960421 DOI: 10.3389/fped.2022.848379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The objective of the study is to evaluate the clinical findings and treatment results of COVID-19 in pediatric cancer patients. STUDY DESIGN The study was designed as a single-center retrospective observational study. Pediatric cancer patients with COVID-19 admitted to the University of Health Sciences Adana City Training and Research Hospital pediatric COVID wards from October 2020 to October 2021 were included. Clinical data and demographic characteristics were retrieved from patient files. RESULTS A total of 45 pediatric cancer patients diagnosed with COVID-19 were included in the study. The mean age of the patients was 8.68 ± 5.16 years (range 1.5-17.5), 62.2% were men, 37.8% were Turkish citizens, and 62.2% were Syrian refugees. A total of 41 patients (91.1%) had leukemia/lymphoma, while 4 (8.9%) had solid tumors. The most common symptoms were fever (66.7%), respiratory (35.6%), and gastrointestinal symptoms (17.8%). Disease severity was evaluated as mild in 46.7%, moderate in 44.4%, and severe in 8.9% of patients. Patients presented with lymphopenia (88.9%), thrombocytopenia (73.3%), anemia (71.1%), and neutropenia (62.2%). Mean hospital length of stay was 15.18 ± 10.34 (range 6-62) days overall and 9.5 ± 2.39 (range 2 to 28) days in the PICU. Intensive care unit admission rate was 8.9%, and mortality rate was 4.4%. Median viral shedding period was 21 days (range 7-52). CONCLUSIONS Our study reveals that the mortality rate, length of hospital stay, and the need for intensive care of pediatric cancer patients with COVID-19 are higher than those of healthy children. Prospective studies with larger sample sizes are needed to further evaluate the clinical findings and treatment results of COVID-19 in pediatric cancer patients.
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Affiliation(s)
- Orkun Tolunay
- Department of Pediatrics, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Ümit Çelik
- Department of Pediatric Infectious Diseases, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Ilknur Arslan
- Department of Pediatrics, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Bugra Tutun
- Department of Pediatrics, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Merve Özkaya
- Department of Pediatrics, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
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Wang L, Li G, Yuan C, Yang Y, Ling G, Zheng J, Zhou Y, Zhang T, Lin W, Lin Z. Progress in the Diagnosis and Treatment of COVID-19 in Children: A Review. Int J Gen Med 2021; 14:8097-8108. [PMID: 34795516 PMCID: PMC8594783 DOI: 10.2147/ijgm.s335888] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/27/2021] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been circulating in many countries around the world, characterized by long incubation period, strong infectivity, strong variability, high population susceptibility and diversified transmission methods. Its causative agent is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compared with adult patients, the clinical manifestations of COVID-19 in children are often dominated by mild or asymptomatic infections, but children are also important virus carriers and play an important role in the transmission of the virus. In addition, some children will show excessive inflammatory response and experience serious complications such as multisystem inflammatory syndrome in children (MIS-C). At present, the research on COVID-19 in children is still imperfect. This article will review epidemiological characteristics, the mechanism of action, variant characteristics, clinical manifestations, auxiliary examinations and treatment of children with COVID-19, in order to provide help for the diagnosis, treatment and research of children with COVID-19.
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Affiliation(s)
- Libo Wang
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Gan Li
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Chang Yuan
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Yuele Yang
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Gongxia Ling
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jinyu Zheng
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Yiyang Zhou
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Tianlei Zhang
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Wei Lin
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Zhenlang Lin
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
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