Department of Health and Social Care (England), London, United Kingdom.
University of Cambridge, Cambridge, United Kingdom.
Clin Infect Dis. 2020 Dec 3;71(9):2469-2479. doi: 10.1093/cid/ciaa556.
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.
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.
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.
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.
目前报道的儿童 2019 冠状病毒病（COVID-19）病例较少，我们对儿童中的流行病学了解甚少，尽管对其他冠状病毒了解更多。我们旨在了解严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的感染率、临床表现、临床结局和传播动态，以便为临床和公共卫生措施提供信息。
我们对所有涉及儿科人群 SARS-CoV-2 的文献进行了快速系统评价和叙述性综合分析。检索词还包括 SARS-CoV 和 MERS-CoV。我们在 3 个数据库中进行了检索，并检索了 11 种主要期刊和出版商的 COVID-19 资源中心。包括中文论文的英文摘要。提取数据并进行叙述性综合分析。
本综述共纳入 24 项关于 COVID-19 的研究。在大型流行病学研究中观察到的病例发生率表明，儿童受 COVID-19 的影响似乎比成年人小。关于发病率的数据有限，但表明儿童同样容易感染。关于临床结局的数据很少，但包括几例无症状感染的报告，以及幼儿疾病的病程较轻，尽管存在影像学异常。没有详细报告严重病例，也没有多少与传播相关的数据。
儿童 COVID-19 的观察病例发生率似乎较低，但与成年人 SARS-CoV-2 的感染率可能相似。这种差异可能是因为儿童无症状或感染太轻微，无法引起医疗关注并在 COVID-19 的观察病例中进行检测和计数。
