Prevalence and determinants of symptomatic COVID-19 infection among children and adolescents in Qatar: a cross-sectional analysis of 11 445 individuals

Epidemiology and clinical features of SARS-CoV-2 infection in children and adolescents in the pre-Omicron era: A global systematic review and meta-analysis

Methods

We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and the World Health Organization (WHO) COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a diagnosis of SARS-CoV-2 infection confirmed either by molecular or antigen tests. We used the Joanna Briggs Institute critical appraisal tools to appraise the study quality and conducted meta-analyses using the random effects model for all outcomes except for race/ethnicity as risk factors of SARS-CoV-2 infection.

Results

We included 237 studies, each reporting at least one of the study outcomes. Based on data from 117 studies, the pooled SARS-CoV-2 positivity rate was 9.30% (95% confidence interval (CI) = 7.15-11.73). Having a comorbidity was identified as a risk factor for SARS-CoV-2 infection (risk ratio (RR) = 1.33; 95% CI = 1.04-1.71) based on data from 49 studies. Most cases in this review presented with mild disease (n = 50; 52.47% (95% CI = 44.03-60.84)). However, 20.70% of paediatric SARS-CoV-2 infections were hospitalised (67 studies), 7.19% required oxygen support (57 studies), 4.26% required intensive care (93 studies), and 2.92% required assisted ventilation (63 studies). The case fatality ratio (n = 119) was 0.87% (95% CI = 0.54-1.28), which included in-hospital and out-of-hospital deaths.

Conclusions

Our data showed that children were at risk for SARS-CoV-2 infections and severe outcomes in the pre-Omicron era. These findings underscore the need for effective vaccination strategies for the paediatric population to protect against the acute and long-term sequelae of COVID-19.

Registration

PROSPERO: CRD42022327680.

Principales modificaciones en la guía de práctica clínica «COVID-19 en pediatría»

Presentamos el resumen de las principales modificaciones surgidas en la guía de práctica clínica «COVID-19 en Pediatría» entre su versión inicial publicada en el año 2021 y la publicada en el año 2022. El documento se ha elaborado siguiendo los pasos estructurados de la medicina basada en la evidencia e incorporando el sistema GRADE para realizar síntesis de la evidencia, con valoración de su calidad y, cuando se consideró apropiado, emitir recomendaciones jerarquizadas (en función de la calidad de la evidencia, los valores y preferencias, el balance entre beneficios, riesgos y costes, la equidad y la factibilidad). En esta actualización se incluyen también los cambios recomendados por los revisores externos.

Se sintetizan las principales modificaciones en los siguientes apartados: epidemiología, clínica, diagnóstico, prevención, tratamiento y vacunas. En el conjunto del conocimiento alcanzado a lo largo del primer año de pandemia, las publicaciones durante el segundo año añaden nuevos datos, sin que en muchas de las áreas se produzcan modificaciones sustanciales. Los principales cambios acaecen en el campo de investigación de las vacunas. Esta actualización finaliza en diciembre de 2021, coincidiendo con el aumento de la infección por ómicron, por lo que será necesario una futura actualización del documento.

Main changes in the "COVID-19 in paediatrics" clinical practice guideline

We present a summary of the main modifications to the “COVID-19 in Paediatrics” clinical practice guideline made from its initial version, published in 2021, and the version published in 2022. The document was developed following the structured steps of evidence-based medicine and applying the GRADE system to synthesize the evidence, assess its quality and, when appropriate, issue graded recommendations (based on the quality of the evidence, values and preferences, the balance between benefits, risks and costs, equity and feasibility). This update also includes the modifications proposed by external reviewers.

We summarised the main modifications in the following sections: epidemiology, clinical features, diagnosis, prevention, treatment and vaccines. In relation to the body of knowledge achieved in the first year of the pandemic, the literature published in the second year contributed additional data, but without substantial modifications in many the areas. The main changes took place in the field of vaccine research. This update was completed in December 2021, coinciding with the emergence of infections by the omicron variant, so the document will need to be updated in the future.