Viner RM, Ward JL, Hudson LD, Ashe M, Patel SV, Hargreaves D, Whittaker E. Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents.
Arch Dis Child 2020;
106:archdischild-2020-320972. [PMID:
33334728 PMCID:
PMC7747494 DOI:
10.1136/archdischild-2020-320972]
[Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE
To undertake a systematic review of reviews of the prevalence of symptoms and signs of COVID-19 in those aged under 20 years.
DESIGN
Narrative systematic review of reviews. PubMed, medRxiv, Europe PMC and COVID-19 Living Evidence Database were searched on 9 October 2020.
SETTING
All settings, including hospitalised and community settings.
PATIENTS
Children and young people (CYP) under age 20 years with laboratory-proven COVID-19.
STUDY REVIEW, DATA EXTRACTION AND QUALITY
Potentially eligible articles were reviewed on title and abstract by one reviewer. Quality was assessed using the modified AMSTARS criteria and data were extracted from included studies by two reviewers.
MAIN OUTCOME MEASURES
Prevalence of symptoms and signs of COVID-19.
RESULTS
1325 studies were identified and 18 reviews were included. Eight were high quality, 7 medium and 3 low quality. All reviews were dominated by studies of hospitalised children. The proportion of asymptomatic CYP ranged from 14.6% to 42%. Fever and cough were the the most common symptoms; proportions with fever ranged from 46% to 64.2% and with cough from 32% to 55.9%. All other symptoms or signs including rhinorrhoea, sore throat, headache, fatigue/myalgia and gastrointestinal symptoms including diarrhoea and vomiting were infrequent, occurring in less than 10%-20%.
CONCLUSIONS
Fever and cough are the most common symptoms in CYP with COVID-19, with other symptoms infrequent. Further research on symptoms in community samples are needed to inform pragmatic identification and testing programmes for CYP.
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