COVID-19 in Children: A Narrative Review

Authors

  • Alireza Razavi Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  • Lotfollah Davoodi Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  • Layla Shojaei Department of Medicine, Research Center for Liver diseases, Keck school of medicine, University of Southern California, Los Angeles, CA, USA
  • Hamed Jafarpour Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

DOI:

https://doi.org/10.3889/oamjms.2020.4714

Keywords:

COVID-19, children, coronavirus, SARS-CoV-2

Abstract

BACKGROUND: In December 2019, coronavirus (CoV) disease 2019 (COVID-19) was detected in Wuhan, China, which is known as severe acute respiratory syndrome CoV 2 (Severe acute respiratory syndrome [SARS]-CoV-2).

AIM: This study attempted a narrative review of the researches about COVID-19 in children.

METHODS: We searched all articles between 2000 and April 2020 in PubMed, Scopus, and ScienceDirect related to COVID-19 in children, using the following terms: “COVID-19,” “coronavirus,” “SARS-CoV-2” in combination with “pediatrics,” or “children.”

RESULTS: The most common method of transmitting the disease to children was through close contact with family members through respiratory droplets. Coinfection is common in pediatric with COVID-19 infection. One of the most important transmission routes is oral feces. The severity of the disease was mild or asymptomatic in most children. The most common clinical symptoms were fever and cough, and gastrointestinal symptoms were more common in children than in adults. Infants and preschoolers had more severe clinical symptoms than older children. The most common radiographic findings from the lungs were bilateral ground-glass opacity. Increased procalcitonin and lactate dehydrogenase should be considered in children. The use of intravenous immunoglobulin, lopinavir/ritonavir, and oseltamivir, along with oxygen therapy, had the greatest effect on improving children’s conditions.

CONCLUSIONS: The most important way to prevent this disease in children is to follow the health tips of family members. Although the number of children with the disease is low, children are vulnerable to infection. Antiviral medications along with the use of muscle relaxants and oxygen therapy have a great impact on children’s condition.

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References

Kahn JS, McIntosh K. History and recent advances in coronavirus discovery. Pediatr Infect Dis J. 2005;24(11 Suppl):S223-S7. PMid:16378050

Fehr AR, Perlman S. Coronaviruses: An Overview of their Replication and Pathogenesis. Berlin, Germany: Springer; 2015. p. 1-23.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: A retrospective review of medical records. Lancet. 2020;395(10226):809-15. https://doi.org/10.1016/s0140-6736(20)30360-3 PMid:32151335

Zhao L, Jha BK, Wu A, Elliott R, Ziebuhr J, Gorbalenya AE, et al. Antagonism of the interferon-induced OAS-RNase L pathway by murine coronavirus ns2 protein is required for virus replication and liver pathology. Cell Host Microbe. 2012;11(6):607-16. https://doi.org/10.1016/j.chom.2012.04.011 PMid:22704621

Phan T. Novel coronavirus: From discovery to clinical diagnostics. Infect Genet Evol. 2020;79:104211. PMid:32007627

Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E. A novel coronavirus emerging in China key questions for impact assessment. N Engl J Med. 2020;382(8):692-4. https://doi.org/10.1056/nejmp2000929 PMid:31978293

Hiroi S, Kawahata T, Furubayashi K. First isolation of human adenovirus Type 85 by molecular analysis of adenoviruses in cases of urethritis. J Med Microbiol. 2020;69(2):265-9. https://doi.org/10.1099/jmm.0.001149 PMid:31971505

de Wilde AH, Snijder EJ, Kikkert M, van Hemert MJ. Host factors in coronavirus replication. Curr Top Microbiol Immunol. 2018;419:1-42.

King AM, Lefkowitz E, Adams MJ, Carstens EB. Virus Taxonomy: 9th Report of the International Committee on Taxonomy of Viruses. Amsterdam, Netherlands: Elsevier; 2011.

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. PMid:32015507

del Rio C, Malani PN. 2019 Novel coronavirus important information for clinicians. JAMA. 2020;323(11):1039–1040. https://doi.org/10.1001/jama.2020.1490 PMid:32022836

Lv L, Li G, Chen J, Liang X, Li Y. Comparative genomic analysis revealed specific mutation pattern between human coronavirus SARS-CoV-2 and Bat-SARSr-CoV RaTG13. BioRxiv. 2020; 27:969006. https://doi.org/10.1101/2020.02.27.969006

Pratelli A. Basic science track entry and release of canine coronavirus from polarized epithelial cells. New Microbiol. 2011;34(1):25. PMid:21344143

Dhama K, Sharun K, Tiwari R, Sircar S, Bhat S, Malik YS, et al. Coronavirus Disease 2019-COVID-19. Geneva: World Health Organization; 2020. https://doi.org/10.20944/preprints202003.0001.v2

Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259-60 PMid:32139904

Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: Experts’ consensus statement. World J Pediatr. 2020;1:1-9. PMid:32034659

Rahimzadeh G, Noghabi ME, Elyaderani FK, Navaeifar MR, Enayati AA, Anari AM, et al. COVID-19 infection in Iranian children: A case series of 9 patients. J Pediatr Rev. 2020;8(2):139-44. https://doi.org/10.32598/jpr.8.2.139

Zhang C, Shi L, Wang FS. Liver injury in COVID-19: Management and challenges. Lancet Gastroenterol Hepatol. 2020;5(5):428-30. PMid:32145190

World Health Organization. Coronavirus Disease 2019 (‎COVID-19) Situation Report, No. 51. Geneva: World Health Organization; 2020.

World Health Organization. Coronavirus Disease 2019 (COVID-19): Situation Report, No. 74. Geneva: World Health Organization; 2020.

Kraemer MU, Yang CH, Gutierrez B, Wu CH, Klein B, Pigott DM, et al. The effect of human mobility and control measures on the COVID-19 epidemic in China. Science. 2020;368(6490):493-7. https://doi.org/10.1126/science.abb4218 PMid:32213647

CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)-United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343-6. https://doi.org/10.15585/mmwr.mm6912e2 PMid:32214079

Riccardo F, Ajelli M, Andrianou X, Bella A, Del Manso M, Fabiani M, et al. Epidemiological characteristics of COVID-19 cases in Italy and estimates of the reproductive numbers one month into the epidemic. medRxiv. 2020;08:20056861. https://doi.org/10.1101/2020.04.08.20056861

del Rio C, Malani PN. COVID-19-new insights on a rapidly changing epidemic. JAMA. 2020;323(14):1339–1340. https://doi.org/10.1001/jama.2020.3072 PMid:32108857

Breban R, Riou J, Fontanet A. Interhuman transmissibility of Middle East respiratory syndrome coronavirus: Estimation of pandemic risk. Lancet. 2013;382(9893):694-9. https://doi.org/10.1016/s0140-6736(13)61492-0 PMid:23831141

Safadi MA. The intriguing features of COVID-19 in children and its impact on the pandemic. J Pediatr. 2020; 7557(20):30141-8. PMid:32305211

Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145. https://doi.org/10.18535/jmscr/v8i4.94 PMid:32064853

Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020;92(6):568-76. https://doi.org/10.1002/jmv.25748

Lam TT, Shum MH, Zhu HC, Tong YG, Ni XB, Liao YS, et al. Identification of 2019-nCoV related coronaviruses in Malayan pangolins in southern China. bioRxiv. 2020;13:945485. https://doi.org/10.1101/2020.02.13.945485

Ji W, Wang W, Zhao X, Zai J, Li X. Homologous recombination within the spike glycoprotein of the newly identified coronavirus may boost cross-species transmission from snake to human. J Med Virol. 2020; 92(4):433-440. https://doi.org/10.1002/jmv.25682

Sarkar B, Ullah MA, Johora FT, Taniya MA, Araf Y. The essential facts of Wuhan novel coronavirus outbreak in China and epitope-based vaccine designing against 2019-nCoV. BioRxiv. 2020; 05:935072. https://doi.org/10.1101/2020.02.05.935072

Drosten C, Meyer B, Müller MA, Corman VM, Al-Masri M, Hossain R, et al. Transmission of MERS-coronavirus in household contacts. N Engl J Med. 2014;371(9):828-35. https://doi.org/10.1056/nejmoa1405858 PMid:25162889

Ong SW, Tan YK, Chia PY, Lee TH, Ng OT, Wong MS, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020;323(16):1610-2. https://doi.org/10.1001/jama.2020.3227 PMid:32129805

Seyedi SJ, Shojaeian R, Hiradfar M, Mohammadipour A, Alamdaran SA. Coronavirus disease 2019 (COVID-19) outbreak in pediatrics and the role of pediatricians: A systematic review. Iran J Pediatr. 2020;30(2):e102784. https://doi.org/10.5812/ijp.102784

Cruz AT, Zeichner SL. COVID-19 in children: Initial characterization of the pediatric disease. Pediatrics. 2020;e20200834:e20200834. https://doi.org/10.1542/peds.2020-0834 PMid:32179659

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: An observational cohort study. Lancet Infect Dis. 2020;3099(20):30198-5. https://doi.org/10.1016/s1473-3099(20)30198-5

Chang TH, Wu JL, Chang LY. Clinical characteristics and diagnostic challenges of pediatric COVID-19: A systematic review and meta-analysis. J Formos Med Assoc. 2020; 119(5):982-989. https://doi.org/10.1016/j.jfma.2020.04.007 PMid:32307322

Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169-74. https://doi.org/10.1002/ppul.24718

Ludvigsson J. Systematic review of COVID-19 in children show milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-95. https://doi.org/10.1111/apa.15270

Lu Q, Shi Y. Coronavirus disease (COVID-19) and neonate: What neonatologist need to know. J Med Virol. 2020;10.1002/jmv.25740. https://doi.org/10.1002/jmv.25740 PMid:32115733

Hong H, Wang Y, Chung HT, Chen CJ. Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children. Pediatr Neonatol. 2020;61(1):131-2. https://doi.org/10.1016/j.pedneo.2020.03.001 PMid:32199864

Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):51. https://doi.org/10.21037/tp.2020.02.06 PMid:32154135

Shen KL, Yang YH. Diagnosis and treatment of 2019 novel coronavirus infection in children: A pressing issue. World J Pediatr. 2020; 1:1-3. PMid:32026147

Du W, Yu J, Wang H, Zhang X, Zhang S, Li Q, et al. Clinical characteristics of COVID-19 in children compared with adults outside of hubei Province in China. Infection. 2020;1:1-8. https://doi.org/10.2139/ssrn.3546097 PMid:32301099

Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 infection in children. N Engl J Med. 2020;382(17):1663-5. PMid:32187458

Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020;e20200702.

Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020;49(1):1-7. PMid:32026148

Lee PI, Hu YL, Chen PY, Huang YC, Hsueh PR. Are children less susceptible to COVID-19? J Microbiol Immunol Infect. 2020;1182(20):30039-6. PMid:32147409

Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19. Pediatr Infect Dis J. 2020;39(5):355-68. PMid:32310621

Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol. 2020;50(6):1-4. https://doi.org/10.1007/s00247-020-04656-7 PMid:32162081

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74. PMid:32007145

Chu DK, Pan Y, Cheng S, Hui KP, Krishnan P, Liu Y, et al. Molecular diagnosis of a novel coronavirus (2019-nCoV) causing an outbreak of pneumonia. Clin Chem. 2020;66(4):549-55. https://doi.org/10.1093/clinchem/hvaa029 PMid:32031583

Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271-80.e8. https://doi.org/10.1016/j.cell.2020.02.052 PMid:32142651

Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3. https://doi.org/10.1016/s0140-6736(20)30185-9 PMid:31986257

Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-71. https://doi.org/10.1038/s41422-020-0282-0 PMid:32020029

Tang A, Xu W, Chen P, Li G, Liu Y, Liu L. A retrospective study of the clinical characteristics of COVID-19 infection in 26 children. medRxiv. 2020; 08:20029710.

See K, Liew S, Ng DC, Chew E, Khoo E, Sam C, et al. COVID-19: Four paediatric cases in Malaysia. Int J Infect Dis. 2020;94:125-7. PMid:32304822

Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: An overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. 2020;39(5):355-68. https://doi.org/10.1097/inf.0000000000002660 PMid:32310621

Ang L, Lee HW, Kim A, Lee JA, Zhang J, Lee MS. Herbal medicine for treatment of children diagnosed with COVID-19: A review of guidelines. Complement Ther Clin Pract. 2020;39:101174. https://doi.org/10.1016/j.ctcp.2020.101174 PMid:32379639

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Published

2020-05-20

How to Cite

1.
Razavi A, Davoodi L, Shojaei L, Jafarpour H. COVID-19 in Children: A Narrative Review. Open Access Maced J Med Sci [Internet]. 2020 May 20 [cited 2024 Apr. 25];8(T1):23-31. Available from: https://oamjms.eu/index.php/mjms/article/view/4714