Komal Shah1, Mudita Upadhyaya2, Yogini Kandre3, Apurvakumar Pandya4, Vishakh Saraf5, Deepak Saxena6, Dileep Mavalankar7. 1. Assistant Professor, Indian Institute of Public Health Gandhinagar - 382042, Gujarat, India. 2. Independent Researcher, 9138 Harbor Hills Drive, Houston Texas, 77054, USA. 3. Programe Associate, Indian Institute of Public Health Gandhinagar - 382042, Gujarat, India. 4. Economic Evaluation Specialist, Indian Institute of Public Health Gandhinagar-382042, Gujarat, India. 5. MPH Student, Indian Institute of Public Health Gandhinagar-382042, Gujarat, India. 6. Professor, Indian Institute of Public Health Gandhinagar-382042, Gujarat, India. 7. Director, Indian Institute of Public Health Gandhinagar - 382042, Gujarat, India.
Abstract
BACKGROUND: Given the limited and diverse nature of published literature related to COVID-19 in pediatrics, it is imperative to provide evidence-based summary of disease characteristics for guiding policy decisions. We aim to provide comprehensive overview of epidemiological, clinical and biomarker profile of COVID-19 infection in pediatric population. METHODS: For this umbrella review, published systematic reviews from PubMed and pre-print databases were screened. Literature search was conducted from December 2019 to April 2021. Details of clinical, radiological, laboratory features were collected from each review. Qualitative observations were synthesized and pooled prevalence of mortality and asymptomatic cases were assessed using meta-analysis. RESULTS: Evidence synthesis of 38 systematic reviews included total 1145 studies and 3,34,398 children and adolescents. Review revealed that COVID-19 is relatively milder with better prognosis in pediatrics. However, patients with comorbidity are at higher risk. Meta-analysis of reviews showed that 21.17% (95% CI: 17.818 to 24.729) of the patients were asymptomatic and mortality rate was 0.12% (95% CI:0.0356-0.246). Though there was no publication bias, significant heterogeneity was observed. Fever (48-64%) and cough (35-55.9%) were common symptoms, affecting almost every alternate patient. Ground glass opacities (prevalence range:27.4-61.5%) was most frequent radiographic observation. Rise in C-reactive protein, lactate dehydrogenase and D-dimer ranged from 14-54%, 12.2-50% and 0.3-67% respectively. Some of the included reviews (44.7%-AMSTAR; 13.2%-GRADE) were of lower quality. CONCLUSION: Current umbrella review provides most updated information regarding characteristics of COVID-19 infection in pediatrics and can be used to guide policy decision regarding vaccination prioritization, early screening and identification of at-risk population.
BACKGROUND: Given the limited and diverse nature of published literature related to COVID-19 in pediatrics, it is imperative to provide evidence-based summary of disease characteristics for guiding policy decisions. We aim to provide comprehensive overview of epidemiological, clinical and biomarker profile of COVID-19infection in pediatric population. METHODS: For this umbrella review, published systematic reviews from PubMed and pre-print databases were screened. Literature search was conducted from December 2019 to April 2021. Details of clinical, radiological, laboratory features were collected from each review. Qualitative observations were synthesized and pooled prevalence of mortality and asymptomatic cases were assessed using meta-analysis. RESULTS: Evidence synthesis of 38 systematic reviews included total 1145 studies and 3,34,398 children and adolescents. Review revealed that COVID-19 is relatively milder with better prognosis in pediatrics. However, patients with comorbidity are at higher risk. Meta-analysis of reviews showed that 21.17% (95% CI: 17.818 to 24.729) of the patients were asymptomatic and mortality rate was 0.12% (95% CI:0.0356-0.246). Though there was no publication bias, significant heterogeneity was observed. Fever (48-64%) and cough (35-55.9%) were common symptoms, affecting almost every alternate patient. Ground glass opacities (prevalence range:27.4-61.5%) was most frequent radiographic observation. Rise in C-reactive protein, lactate dehydrogenase and D-dimer ranged from 14-54%, 12.2-50% and 0.3-67% respectively. Some of the included reviews (44.7%-AMSTAR; 13.2%-GRADE) were of lower quality. CONCLUSION: Current umbrella review provides most updated information regarding characteristics of COVID-19infection in pediatrics and can be used to guide policy decision regarding vaccination prioritization, early screening and identification of at-risk population.
Authors: T Hernández-Sampelayo; J Gómez-Pavón; J González Del Castillo; M C Martín-Delgado; F J Martín Sánchez; M Martínez-Sellés; J M Molero García; S Moreno Guillén; F J Rodríguez-Artalejo; J Ruiz-Galiana; R Cantón; P De Lucas Ramos; A García-Botella; A García-Lledó; P Calvo Rey; E Bouza Journal: Rev Esp Quimioter Date: 2022-03-15 Impact factor: 2.515