Li Bingbing, Zhang Shan, Zhang Ruili, Chen Xi, Wang Yong, Zhu Changlian
Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China.
Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Front Pediatr. 2020 Nov 2;8:591132. doi: 10.3389/fped.2020.591132. eCollection 2020.
Given the relatively low rate and limited publicly available data regarding children with SARS-CoV-2 infection, this knowledge gap should be addressed with urgency. This systematic review with meta-analysis aimed to evaluate the epidemiological spectrum and clinical characteristics of children infected with SARS-CoV-2. Relevant international and Chinese public databases were systematically searched to identify all case studies from January 1, 2020 to May 7, 2020. This study consisted of 96 studies involving 7004 cases. The mean age of pediatric cases was 6.48 years (95% CI 52.0-77.5), 90% had household contact, and 66% presented with mild to moderate clinical syndromes. The main symptoms were fever (47%, 95% CI 41-53%) and cough (42%, 95% CI 36-48%). About 23% of children were asymptomatic, 27% had comorbidity, and 29% had a co-infection. The pooled mean incubation period was 9.57 days (95% CI 7.70-11.44). The shedding of SARS-CoV-2 in the upper respiratory tract lasted 11.43 days, and 75% of patients had virus particles in their stool. A total of 34% of the children had neutropenia and 26% had lymphocytosis. Interferon-alpha (81%) was the most commonly used antiviral drug in the children. The discharge and death rates were 79 and 1%. In conclusion, the transmissibility of pediatric COVID-19 should be not ignored because of the relatively long incubation period, shedding duration, and mild clinical syndromes.
鉴于感染新型冠状病毒（SARS-CoV-2）的儿童发病率相对较低且公开数据有限，这一知识空白亟待填补。本项系统评价及荟萃分析旨在评估感染SARS-CoV-2的儿童的流行病学特征和临床特点。我们系统检索了相关国际及中国公共数据库，以确定2020年1月1日至2020年5月7日期间的所有病例研究。本研究纳入了96项研究，涉及7004例病例。儿科病例的平均年龄为6.48岁（95%置信区间52.0 - 77.5），90%有家庭接触史，66%表现为轻至中度临床症状。主要症状为发热（47%，95%置信区间41 - 53%）和咳嗽（42%，95%置信区间36 - 48%）。约23%的儿童无症状，27%有合并症，29%有合并感染。汇总后的平均潜伏期为9.57天（95%置信区间7.70 - 11.44）。SARS-CoV-2在上呼吸道的排毒持续11.43天，75%的患者粪便中有病毒颗粒。共有34%的儿童出现中性粒细胞减少，26%出现淋巴细胞增多。α-干扰素（81%）是儿童中最常用的抗病毒药物。出院率和死亡率分别为79%和1%。总之，由于儿童新型冠状病毒肺炎（COVID-19）潜伏期相对较长、排毒持续时间较长且临床症状较轻，其传播性不容忽视。
