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01-07-2020 | Coronavirus | Review

SARS-COV-2 infection in children and newborns: a systematic review

Authors: Ilaria Liguoro, Chiara Pilotto, Margherita Bonanni, Maria Elena Ferrari, Anna Pusiol, Agostino Nocerino, Enrico Vidal, Paola Cogo

Published in: European Journal of Pediatrics | Issue 7/2020

Abstract

A recent outbreak of a novel Coronavirus responsible for a Severe Acute Respiratory Syndrome (SARS-CoV-2) is spreading globally. The aim of this study was to systematically review main clinical characteristics and outcomes of SARS-CoV-2 infections in pediatric age. An electronic search was conducted in PubMed database. Papers published between 1 January and 1 May 2020 including children aged 0–18 years were selected. Sixty-two studies and three reviews were included, with a total sample size of 7480 children (2428/4660 males, 52.1%; weighted mean age 7.6 years). Patients showed mainly mild (608/1432, 42.5%) and moderate (567/1432, 39.6%) signs of the infection. About 2% of children were admitted to the pediatric intensive care unit. The most commonly described symptoms were fever (51.6%) and cough (47.3%). Laboratory findings were often unremarkable. Children underwent a chest CT scan in 73.9% of all cases, and 32.7% resulted normal. Overall, the estimated mortality was 0.08%. A higher proportion of newborns was severely ill (12%) and dyspnea was the most common reported sign (40%).

Conclusion: SARS-CoV-2 affects children less severely than adults. Laboratory and radiology findings are mainly nonspecific. Larger epidemiological and clinical cohort studies are needed to better understand possible implications of COVID-19 infection in children.

What is Known: • A novel Coronavirus has been recently identified as responsible for a new Severe Acute Respiratory Syndrome (SARS-CoV-2) spreading globally. • There is limited evidence on SARS-CoV2 infection in children.
What is New: • Systematically reviewed available evidence showed that children with SARS-CoV-2 infection may have a less severe pattern of disease in comparison to adults. • Blood tests and radiology findings are mainly nonspecific in children but may help to identify those who are severely ill.

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Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, Liu T, Zhao J, Liu M, Tu W, Chen C, Jin L, Yang R, Wang Q, Zhou S, Wang R, Liu H, Luo Y, Liu Y, Shao G, Li H, Tao Z, Yang Y, Deng Z, Liu B, Ma Z, Zhang Y, Shi G, Lam TTY, Wu JT, Gao GF, Cowling BJ, Yang B, Leung GM, Feng Z (2020) Early transmission dynamics in Wuhan, China, of novel Coronavirus-infected pneumonia. N Engl J Med 382:1199–1207. https://doi.org/10.1056/NEJMoa2001316CrossRefPubMedPubMedCentral

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W, China Novel Coronavirus Investigating and Research Team (2020) A novel Coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382:727–733. https://doi.org/10.1056/NEJMoa2001017CrossRefPubMedPubMedCentral

Drosten C, Günther S, Preiser W, van der Werf S, Brodt HR, Becker S, Rabenau H, Panning M, Kolesnikova L, Fouchier RAM, Berger A, Burguière AM, Cinatl J, Eickmann M, Escriou N, Grywna K, Kramme S, Manuguerra JC, Müller S, Rickerts V, Stürmer M, Vieth S, Klenk HD, Osterhaus ADME, Schmitz H, Doerr HW (2003) Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med 348:1967–1976. https://doi.org/10.1056/NEJMoa030747CrossRefPubMed

de Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L, Fouchier RAM, Galiano M, Gorbalenya AE, Memish ZA, Perlman S, Poon LLM, Snijder EJ, Stephens GM, Woo PCY, Zaki AM, Zambon M, Ziebuhr J (2013) Middle East respiratory syndrome Coronavirus (MERS-CoV): announcement of the Coronavirus study group. J Virol 87:7790–7792. https://doi.org/10.1128/JVI.01244-13CrossRefPubMedPubMedCentral

Ashour HM, Elkhatib WF, Rahman MM, Elshabrawy HA (2020) Insights into the recent 2019 novel Coronavirus (SARS-CoV-2) in light of past human Coronavirus outbreaks. Pathogens 9. https://doi.org/10.3390/pathogens9030186

Coronaviridae Study Group of the International Committee on Taxonomy of Viruses (2020) The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 5:536–544. https://doi.org/10.1038/s41564-020-0695-zCrossRef

WHO Director-General’s opening remarks at the media briefing on COVID-19—11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19%2D%2D-11-march-2020.

Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).

Dong E, Du H, Gardner L (2020) An interactive web-based dashboard to track COVID-19 in real time. The Lancet Infectious Diseases 0: https://doi.org/10.1016/S1473-3099(20)30120-1

10.

Lu X, Zhang L, Du H et al (2020) SARS-CoV-2 infection in children. N Engl J Med 382:1663–1665. https://doi.org/10.1056/NEJMc2005073CrossRefPubMed

11.

Liu W, Zhang Q, Chen J et al (2020) Detection of Covid-19 in children in early January 2020 in Wuhan, China. New England Journal of Medicine

12.

Wu Z, McGoogan JM (2020) Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 323:1239. https://doi.org/10.1001/jama.2020.2648CrossRefPubMed

13.

Livingston E, Bucher K (2020) Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 323:1335. https://doi.org/10.1001/jama.2020.4344CrossRefPubMed

14.

COVID-19 Integrated Surveillance _GB—ISS. https://www.iss.it/covid-19-integrated-surveillance. Accessed 30 Mar 2020

15.

Onder G, Rezza G, Brusaferro S (2020) Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. https://doi.org/10.1001/jama.2020.4683

16.

Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, Tong S (2020) Epidemiological characteristics of 2143 pediatric patients with 2019 Coronavirus disease in China. Pediatrics.:e20200702. https://doi.org/10.1542/peds.2020-0702

17.

Schwartz DA (2020) An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal Coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. https://doi.org/10.5858/arpa.2020-0901-SA

18.

Yang H, Wang C, Poon LC (2020) Novel coronavirus infection and pregnancy. Ultrasound Obstet Gynecol 55:435–437. https://doi.org/10.1002/uog.22006CrossRefPubMedPubMedCentral

19.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, Li J, Zhao D, Xu D, Gong Q, Liao J, Yang H, Hou W, Zhang Y (2020) Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 395:809–815. https://doi.org/10.1016/S0140-6736(20)30360-3CrossRefPubMedPubMedCentral

20.

Peng Z, Wang J, Mo Y, Duan W, Xiang G, Yi M, Bao L, Shi Y (2020) Unlikely SARS-CoV-2 vertical transmission from mother to child: a case report. J Infect Public Health 13:818–820. https://doi.org/10.1016/j.jiph.2020.04.004CrossRefPubMedPubMedCentral

21.

Zeng H, Xu C, Fan J, Tang Y, Deng Q, Zhang W, Long X (2020) Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA. https://doi.org/10.1001/jama.2020.4861

22.

Dong L, Tian J, He S, Zhu C, Wang J, Liu C, Yang J (2020) Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. JAMA. https://doi.org/10.1001/jama.2020.4621

23.

Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, Zhou W (2020) Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan. China JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2020.0878

24.

Wang L, Shi Y, Xiao T et al (2020) Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (first edition). Ann Transl Med 8:47. https://doi.org/10.21037/atm.2020.02.20CrossRefPubMedPubMedCentral

25.

CDC (2020) Coronavirus Disease 2019 (COVID-19). In: Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html.

26.

Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097CrossRefPubMedPubMedCentral

27.

Munn Z, Moola S, Riitano D, Lisy K (2014) The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag 3:123–128. https://doi.org/10.15171/ijhpm.2014.71CrossRefPubMedPubMedCentral

28.

Chen Z-M, Fu J-F, Shu Q, Chen YH, Hua CZ, Li FB, Lin R, Tang LF, Wang TL, Wang W, Wang YS, Xu WZ, Yang ZH, Ye S, Yuan TM, Zhang CM, Zhang YY (2020) Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. https://doi.org/10.1007/s12519-020-00345-5

29.

Korean Society of Infectious Diseases, Korean Society of Pediatric Infectious Diseases, Korean Society of Epidemiology et al (2020) Report on the epidemiological features of Coronavirus Disease 2019 (COVID-19) outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med Sci 35:e112. https://doi.org/10.3346/jkms.2020.35.e112CrossRef

30.

D’Antiga L (2020) Coronaviruses and immunosuppressed patients. The facts during the third epidemic. Liver Transpl. https://doi.org/10.1002/lt.25756

31.

Sun D, Li H, Lu X-X, Xiao H, Ren J, Zhang FR, Liu ZS (2020) Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr. https://doi.org/10.1007/s12519-020-00354-4

32.

Zheng F, Liao C, Fan Q-H, Chen HB, Zhao XG, Xie ZG, Li XL, Chen CX, Lu XX, Liu ZS, Lu W, Chen CB, Jiao R, Zhang AM, Wang JT, Ding XW, Zeng YG, Cheng LP, Huang QF, Wu J, Luo XC, Wang ZJ, Zhong YY, Bai Y, Wu XY, Jin RM (2020) Clinical characteristics of children with Coronavirus Disease 2019 in Hubei. China Curr Med Sci 40:275–280. https://doi.org/10.1007/s11596-020-2172-6CrossRefPubMed

33.

Wang XF, Yuan J, Zheng YJ et al (2020) [retracted: Clinical and epidemiological characteristics of 34 children with 2019 novel coronavirus infection in Shenzhen]. Zhonghua Er Ke Za Zhi 58:E008. https://doi.org/10.3760/cma.j.issn.0578-1310.2020.0008

34.

Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D (2020) Clinical and CT features in pediatric patients with COVID-19 infection: different points from adults. Pediatr Pulmonol 55:1169–1174. https://doi.org/10.1002/ppul.24718CrossRefPubMedPubMedCentral

35.

Feng K, Yun YX, Wang XF et al (2020) Analysis of CT features of 15 children with 2019 novel coronavirus infection. Zhonghua Er Ke Za Zhi 58:E007. https://doi.org/10.3760/cma.j.issn.0578-1310.2020.0007CrossRefPubMed

36.

Wang D, Ju XL, Xie F et al (2020) Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Zhonghua Er Ke Za Zhi 58:E011. https://doi.org/10.3760/cma.j.cn112140-20200225-00138CrossRef

37.

Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, Guo Q, Sun X, Zhao D, Shen J, Zhang H, Liu H, Xia H, Tang J, Zhang K, Gong S (2020) Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med 26:1–4. https://doi.org/10.1038/s41591-020-0817-4CrossRef

38.

Cai J, Xu J, Lin D, Yang, Xu L, Qu Z, Zhang Y, Zhang H, Jia R, Liu, Wang X, Ge Y, Xia A, Tian H, Chang H, Wang C, Li J, Wang J, Zeng M (2020) A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa198

39.

Liu H, Liu F, Li J, Zhang T, Wang D, Lan W (2020) Clinical and CT imaging features of the COVID-19 pneumonia: focus on pregnant women and children. J Inf Secur 80:e7–e13. https://doi.org/10.1016/j.jinf.2020.03.007CrossRef

40.

Li W, Cui H, Li K, et al (2020) Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol 1–4. https://doi.org/10.1007/s00247-020-04656-7

41.

Ji L-N, Chao S, Wang Y-J, Li XJ, Mu XD, Lin MG, Jiang RM (2020) Clinical features of pediatric patients with COVID-19: a report of two family cluster cases. World J Pediatr. https://doi.org/10.1007/s12519-020-00356-2

42.

Zhou Y, Yang G-D, Feng K, Huang H, Yun YX, Mou XY, Wang LF (2020) Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children. Zhongguo Dang Dai Er Ke Za Zhi 22:215–220PubMed

43.

Park JY, Han MS, Park KU, Kim JY, Choi EH (2020) First pediatric case of Coronavirus Disease 2019 in Korea. J Korean Med Sci 35:e124. https://doi.org/10.3346/jkms.2020.35.e124CrossRefPubMedPubMedCentral

44.

Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, Wang Z, Li J, Li J, Feng C, Zhang Z, Wang L, Peng L, Chen L, Qin Y, Zhao D, Tan S, Yin L, Xu J, Zhou C, Jiang C, Liu L (2020) Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci 63:364–374. https://doi.org/10.1007/s11427-020-1643-8CrossRefPubMedPubMedCentral

45.

Chan JF-W, Yuan S, Kok K-H, To KKW, Chu H, Yang J, Xing F, Liu J, Yip CCY, Poon RWS, Tsoi HW, Lo SKF, Chan KH, Poon VKM, Chan WM, Ip JD, Cai JP, Cheng VCC, Chen H, Hui CKM, Yuen KY (2020) A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 395:514–523. https://doi.org/10.1016/S0140-6736(20)30154-9CrossRefPubMedPubMedCentral

46.

Cai JH, Wang XS, Ge YL, Xia AM, Chang HL, Tian H, Zhu YX, Wang QR, Zeng JS (2020) First case of 2019 novel coronavirus infection in children in Shanghai. Zhonghua Er Ke Za Zhi 58:86–87. https://doi.org/10.3760/cma.j.issn.0578-1310.2020.02.002CrossRefPubMed

47.

Chen F, Liu ZS, Zhang FR, Xiong RH, Chen Y, Cheng XF, Wang WY, Ren J (2020) First case of severe childhood novel coronavirus pneumonia in China. Zhonghua Er Ke Za Zhi 58:179–182. https://doi.org/10.3760/cma.j.issn.0578-1310.2020.03.003CrossRefPubMed

48.

Kam K, Yung CF, Cui L, et al A well infant with Coronavirus Disease 2019 with high viral load. Clin Infect Dis https://doi.org/10.1093/cid/ciaa201

49.

Zhang G-X, Zhang A-M, Huang L, Cheng LY, Liu ZX, Peng XL, Wang HW (2020) Twin girls infected with SARS-CoV-2. Zhongguo Dang Dai Er Ke Za Zhi 22:221–225PubMed

50.

Zhao R, Shen X, Yu K, Sheng (2020) [A case of children with 2019 novel Coronavirus infection]. Zhejiang Med J

51.

Wei M, Yuan J, Liu Y, Fu T, Yu X, Zhang ZJ (2020) Novel Coronavirus infection in hospitalized infants under 1 year of age in China. JAMA. 323:1313. https://doi.org/10.1001/jama.2020.2131CrossRefPubMedPubMedCentral

52.

Shen K-L, Yang Y-H (2020) Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue. World J Pediatr. https://doi.org/10.1007/s12519-020-00344-6

53.

Lou XX, Shi CX, Zhou CC, Tian YS (2020) Three children who recovered from novel coronavirus 2019 pneumonia. J Paediatr Child Health 56:650–651. https://doi.org/10.1111/jpc.14871CrossRefPubMed

54.

Qian G, Yang N, Ma AHY, Wang L, Li G, Chen X, Chen X (2020) A COVID-19 transmission within a family cluster by presymptomatic infectors in China. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa316

55.

Su L, Ma X, Yu H, Zhang Z, Bian P, Han Y, Sun J, Liu Y, Yang C, Geng J, Zhang Z, Gai Z (2020) The different clinical characteristics of corona virus disease cases between children and their families in China—the character of children with COVID-19. Emerg Microbes Infect 9:707–713. https://doi.org/10.1080/22221751.2020.1744483CrossRefPubMed

56.

Tang A, Tong Z-D, Wang H-L, Dai YX, Li KF, Liu JN, Wu WJ, Yuan C, Yu ML, Li P, Yan JB (2020) Detection of novel Coronavirus by RT-PCR in stool specimen from asymptomatic child. China Emerging Infect Dis 26. https://doi.org/10.3201/eid2606.200301

57.

Li Y, Guo F, Cao Y, Li LF, Guo YJ (2020) Insight into COVID-2019 for pediatricians. Pediatr Pulmonol 55:E1–E4. https://doi.org/10.1002/ppul.24734CrossRefPubMedPubMedCentral

58.

Pan X, Chen D, Xia Y, Wu X, Li T, Ou X, Zhou L, Liu J (2020) Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis 20:410–411. https://doi.org/10.1016/S1473-3099(20)30114-6CrossRefPubMedPubMedCentral

59.

Xing Y, Ni W, Wu Q, et al (2020) Prolonged presence of SARS-CoV-2 in feces of pediatric patients during the convalescent phase. medRxiv 2020.03.11.20033159. https://doi.org/10.1101/2020.03.11.20033159

60.

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D (2020) Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. https://doi.org/10.1016/S1473-3099(20)30198-5

61.

Zhang C, Gu J, Chen Q, Deng NA et al. (2020) Clinical Characteristics of 34 Children with Coronavirus Disease-2019 in the West of China: a Multiple-center Case Series. medRxiv

62.

Chen C, Cao M, Peng L, et al (2020) Coronavirus Disease-19 among children outside Wuhan, China. Social Science Research Network, Rochester, NY

63.

Wang S, Guo L, Chen L, Liu W, Cao Y, Zhang J, Feng L (2020) A case report of neonatal COVID-19 infection in China. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa225

64.

Cui Y, Tian M, Huang D, Wang X, Huang Y, Fan L, Wang L, Chen Y, Liu W, Zhang K, Wu Y, Yang Z, Tao J, Feng J, Liu K, Ye X, Wang R, Zhang X, Zha Y (2020) A 55-day-old female infant infected with COVID 19: presenting with pneumonia, liver injury, and heart damage. J Infect Dis 221:1775–1781. https://doi.org/10.1093/infdis/jiaa113CrossRefPubMed

65.

Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, Xia S, Zhou W (2020) Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr 9:51–60. https://doi.org/10.21037/tp.2020.02.06CrossRefPubMedPubMedCentral

66.

Lu Q, Shi Y (2020) Coronavirus disease (COVID-19) and neonate: what neonatologist need to know. J Med Virol 92:564–567. https://doi.org/10.1002/jmv.25740CrossRefPubMed

67.

Zhang YH, Lin DJ, Xiao MF et al (2020) 2019 novel coronavirus infection in a three-month-old baby. Zhonghua Er Ke Za Zhi 58:182–184. https://doi.org/10.3760/cma.j.issn.0578-1310.2020.03.004CrossRefPubMed

68.

Zeng LK, Tao XW, Yuan WH et al (2020) First case of neonate infected with novel coronavirus pneumonia in China. Zhonghua Er Ke Za Zhi 58:E009. https://doi.org/10.3760/cma.j.issn.0578-1310.2020.0009CrossRefPubMed

69.

Le HT, Nguyen LV, Tran DM et al (2020) The first infant case of COVID-19 acquired from a secondary transmission in Vietnam. Lancet Child Adolesc Health 4:405–406. https://doi.org/10.1016/S2352-4642(20)30091-2CrossRefPubMedPubMedCentral

70.

Wang J, Wang D, Chen G-C, Tao XW, Zeng LK (2020) SARS-CoV-2 infection with gastrointestinal symptoms as the first manifestation in a neonate. Zhongguo Dang Dai Er Ke Za Zhi 22:211–214PubMed

71.

Shen Q, Guo W, Guo T, Li J, He W, Ni S, Ouyang X, Liu J, Xie Y, Tan X, Zhou Z, Peng H (2020) Novel coronavirus infection in children outside of Wuhan. China Pediatr Pulmonol 55:1424–1429. https://doi.org/10.1002/ppul.24762CrossRefPubMed

72.

Han Y-N, Feng Z-W, Sun L-N, Ren XX, Wang H, Xue YM, Wang Y, Fang Y (2020) A comparative-descriptive analysis of clinical characteristics in 2019-Coronavirus-infected children and adults. J Med Virol. https://doi.org/10.1002/jmv.25835

73.

Kamali Aghdam M, Jafari N, Eftekhari K (2020) Novel coronavirus in a 15-day-old neonate with clinical signs of sepsis, a case report. Infect Dis (Lond) 52:1–3. https://doi.org/10.1080/23744235.2020.1747634CrossRef

74.

Canarutto D, Priolo A, Russo G, Pitea M, Vigone MC, Barera G (2020) COVID-19 infection in a paucisymptomatic infant: raising the index of suspicion in epidemic settings. Pediatr Pulmonol 55:E4–E5. https://doi.org/10.1002/ppul.24754CrossRefPubMed

75.

Li H, Chen K, Liu M, Xu H, Xu Q (2020) The profile of peripheral blood lymphocyte subsets and serum cytokines in children with 2019 novel coronavirus pneumonia. J Inf Secur. https://doi.org/10.1016/j.jinf.2020.04.001

76.

CDC COVID-19 Response Team (2020) Coronavirus Disease 2019 in children—United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep 69:422–426. https://doi.org/10.15585/mmwr.mm6914e4CrossRefPubMedCentral

77.

Parri N, Lenge M, Buonsenso D, Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group (2020) Children with Covid-19 in pediatric emergency departments in Italy. N Engl J Med. https://doi.org/10.1056/NEJMc2007617

78.

Tagarro A, Epalza C, Santos M, Sanz-Santaeufemia FJ, Otheo E, Moraleda C, Calvo C (2020) Screening and severity of Coronavirus Disease 2019 (COVID-19) in children in Madrid, Spain. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2020.1346

79.

See KC, Liew SM, Ng DCE, Chew EL, Khoo EM, Sam CH, Sheena D, Zahilah Filzah Z, Chin SY, Lee PY, Tan LP, Farah Najwa Z, Sabrina S, Them WW, Saipriya T, Muhammad Zamakhshari ZA, Cheah WK, Peariasamy K, Goh PP, Ibrahim H (2020) COVID-19: four paediatric cases in Malaysia. Int J Infect Dis 94:125–127. https://doi.org/10.1016/j.ijid.2020.03.049CrossRefPubMedPubMedCentral

80.

Tan Y-P, Tan B-Y, Pan J, Wu J, Zeng SZ, Wei HY (2020) Epidemiologic and clinical characteristics of 10 children with coronavirus disease 2019 in Changsha, China. J Clin Virol 127:104353. https://doi.org/10.1016/j.jcv.2020.104353CrossRefPubMedPubMedCentral

81.

Du W, Yu J, Wang H et al (2020) Clinical characteristics of COVID-19 in children compared with adults in Shandong Province, China. Infection. https://doi.org/10.1007/s15010-020-01427-2

82.

Buonsenso D, Costa S, Sanguinetti M, Cattani P, Posteraro B, Marchetti S, Carducci B, Lanzone A, Tamburrini E, Vento G, Valentini P (2020) Neonatal late onset infection with severe acute respiratory syndrome Coronavirus 2. Am J Perinatol. https://doi.org/10.1055/s-0040-1710541

83.

Han MS, Seong M-W, Heo EY, Park JH, Kim N, Shin S, Cho SI, Park SS, Choi EH (2020) Sequential analysis of viral load in a neonate and her mother infected with SARS-CoV-2. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa447

84.

Zhu L, Wang J, Huang R, Liu L, Zhao H, Wu C, Zhu C (2020) Clinical characteristics of a case series of children with coronavirus disease 2019. Pediatr Pulmonol 55:1430–1432. https://doi.org/10.1002/ppul.24767CrossRefPubMedPubMedCentral

85.

Henry BM, Lippi G, Plebani M (2020) Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med 0. https://doi.org/10.1515/cclm-2020-0272

86.

Ludvigsson JF (2020) Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 109:1088–1095. https://doi.org/10.1111/apa.15270CrossRefPubMed

87.

Castagnoli R, Votto M, Licari A, Brambilla I, Bruno R, Perlini S, Rovida F, Baldanti F, Marseglia GL (2020) Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2020.1467

88.

Guan W-J, Liang W-H, Zhao Y, Liang HR, Chen ZS, Li YM, Liu XQ, Chen RC, Tang CL, Wang T, Ou CQ, Li L, Chen PY, Sang L, Wang W, Li JF, Li CC, Ou LM, Cheng B, Xiong S, Ni ZY, Xiang J, Hu Y, Liu L, Shan H, Lei CL, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Cheng LL, Ye F, Li SY, Zheng JP, Zhang NF, Zhong NS, He JX (2020) Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis. Eur Respir J:2000547. https://doi.org/10.1183/13993003.00547-2020

89.

Wang Y, Wang Y, Chen Y, Qin Q (2020) Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol 92:568–576. https://doi.org/10.1002/jmv.25748CrossRefPubMed

90.

Muus C, Luecken MD, Eraslan G, et al (2020) Integrated analyses of single-cell atlases reveal age, gender, and smoking status associations with cell type-specific expression of mediators of SARS-CoV-2 viral entry and highlights inflammatory programs in putative target cells. bioRxiv 2020.04.19.049254. https://doi.org/10.1101/2020.04.19.049254

91.

Guan W-J, Ni Z-Y, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS, China Medical Treatment Expert Group for Covid-19 (2020) Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med 382:1708–1720. https://doi.org/10.1056/NEJMoa2002032CrossRefPubMed

92.

Jones TC, Mühlemann B, Veith T, et al An analysis of SARS-CoV-2 viral load by patient age. 19

93.

Song R, Han B, Song M, Wang L, Conlon CP, Dong T, Tian D, Zhang W, Chen Z, Zhang F, Shi M, Li X (2020) Clinical and epidemiological features of COVID-19 family clusters in Beijing. China J Infect. https://doi.org/10.1016/j.jinf.2020.04.018

94.

Zimmermann P, Curtis N (2020) Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis. Treatment and Prevention Options in Children The Pediatric Infectious Disease Journal 1:355–368. https://doi.org/10.1097/INF.0000000000002660CrossRef

95.

Gu J, Han B, Wang J (2020) COVID-19: gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology. 158:1518–1519. https://doi.org/10.1053/j.gastro.2020.02.054CrossRefPubMed

96.

Leung WK, To K-F, Chan PKS et al (2003) Enteric involvement of severe acute respiratory syndrome-associated coronavirus infection. Gastroenterology 125:1011–1017. https://doi.org/10.1016/s0016-5085(03)01215-0CrossRefPubMed

97.

Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, et al (2020) Vertical transmission of Coronavirus Disease 19 (COVID-19) from infected pregnant mothers to neonates: a review. Fetal Pediatr Pathol 1–5. https://doi.org/10.1080/15513815.2020.1747120

98.

Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case–control study | medRxiv. https://doi.org/10.1101/2020.03.10.20033605v1. Accessed 2 Apr 2020

99.

Yang X, Yu Y, Xu J, Shu H, Xia J', Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y, Pan S, Zou X, Yuan S, Shang Y (2020) Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 8:475–481. https://doi.org/10.1016/S2213-2600(20)30079-5CrossRefPubMedPubMedCentral

100.

Lippi G, Plebani M (2020) Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chim Acta 505:190–191. https://doi.org/10.1016/j.cca.2020.03.004CrossRefPubMedPubMedCentral

101.

Sellers SA, Hagan RS, Hayden FG, Fischer WA (2017) The hidden burden of influenza: a review of the extra-pulmonary complications of influenza infection. Influenza Other Respir Viruses 11:372–393. https://doi.org/10.1111/irv.12470CrossRefPubMedPubMedCentral

102.

Zhang G, Zhang J, Wang B, Zhu X, Wang Q, Qiu S (2020) Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis. Respir Res 21:74. https://doi.org/10.1186/s12931-020-01338-8CrossRefPubMedPubMedCentral

103.

Chai X, Hu L, Zhang Y, et al (2020) Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv 2020.02.03.931766. https://doi.org/10.1101/2020.02.03.931766

104.

Silverstein WK, Stroud L, Cleghorn GE, Leis JA (2020) First imported case of 2019 novel coronavirus in Canada, presenting as mild pneumonia. Lancet 395:734. https://doi.org/10.1016/S0140-6736(20)30370-6CrossRefPubMedPubMedCentral

105.

Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, Ji W (2020) Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 200432:200432. https://doi.org/10.1148/radiol.2020200432CrossRef

106.

Buonsenso D, Piano A, Raffaelli F, et al Point-of-care lung ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak. 5

107.

Denina M, Scolfaro C, Silvestro E, Pruccoli G, Mignone F, Zoppo M, Ramenghi U, Garazzino S (2020) Lung ultrasound in children with COVID-19. Pediatrics.:e20201157. https://doi.org/10.1542/peds.2020-1157

108.

Chiotos K, Hayes M, Kimberlin DW, Jones SB, James SH, Pinninti SG, Yarbrough A, Abzug MJ, MacBrayne CE, Soma VL, Dulek DE, Vora SB, Waghmare A, Wolf J, Olivero R, Grapentine S, Wattier RL, Bio L, Cross SJ, Dillman NO, Downes KJ, Timberlake K, Young J, Orscheln RC, Tamma PD, Schwenk HT, Zachariah P, Aldrich M, Goldman DL, Groves HE, Lamb GS, Tribble AC, Hersh AL, Thorell EA, Denison MR, Ratner AJ, Newland JG, Nakamura MM (2020) Multicenter initial guidance on use of antivirals for children with COVID-19/SARS-CoV-2. J Pediatric Infect Dis Soc. https://doi.org/10.1093/jpids/piaa045

109.

Organization WH (2020) Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance, 28 January 2020

Title: SARS-COV-2 infection in children and newborns: a systematic review
Authors: Ilaria Liguoro
Chiara Pilotto
Margherita Bonanni
Maria Elena Ferrari
Anna Pusiol
Agostino Nocerino
Enrico Vidal
Paola Cogo
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Coronavirus
SARS-CoV-2
COVID-19
Published in: European Journal of Pediatrics / Issue 7/2020
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-020-03684-7

At a glance: The STEP trials

Springer Medicine

SARS-COV-2 infection in children and newborns: a systematic review

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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