Abstract
Background: The COVID-19 pandemic has caused a global havoc with our
limited understanding of the SARS-CoV-2, disease manifestations and
management. Inadequacy of available data in pediatric patients coupled
with evolving disease course makes it imperative to conduct a
meta-analysis assessing the results of pediatric COVID-19 studies over
the course of the pandemic. Methods: A random-effect meta-analysis was
conducted using PRISMA guidelines. Two databases were screened for
pediatric COVID-19 studies and selected articles reviewed for
demographic, co-morbidities, clinical manifestations, laboratory and
radiological evaluation, treatment and outcomes. Prevalence with mean
and 95% confidence interval was calculated. Results: Out of 1703
articles, 37 articles comprising of 993 patients for a period of over
six months and 72 variables were selected. This meta-analysis revealed
that one-fourth of patients were asymptomatic (23.8%, 95% CI
17.6-31.2%) Fever (52.5%, 95% CI 45.7–59.1%) and cough (47.6%,
95% CI 41.2–54.0%) were the most common symptoms. The most frequently
encountered white blood count abnormalities were neutropenia (16.6%,
95% CI 10.2-25.8%), lymphocytosis (15.3%, 95% CI 9.9–23.0%) and
leukopenia (13.9%, 95% CI 10.1–18.8%). Ground glass opacities were
the most common radiological finding of children with COVID-19 (35.9%,
95% CI 29.4-43%). The hospitalization rate was 95.9% (95% CI
91.9-98.0%) of which 11.2% (95% CI 4.7-24.2) were ICU admissions, and
4.2% (95% CI 2.6-6.9%) died. Conclusion: Majority of pediatric
patients are asymptomatic or have mild manifestations similar to other
upper respiratory viruses. Serious disease and death occurred in 15.4%.
More studies are needed from a wider geographic area as the pandemic
continues.