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Revisión sistemática

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Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data.

Revista Pediatric research
Año 2022
Enlaces Pubmed DOI PubMed Central

Este artículo está incluido en 1 Síntesis amplia 22 Síntesis amplias (1 referencia)

Este artículo incluye 22 Estudios primarios 22 Estudios primarios (22 referencias)

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BACKGROUND: There are sparse patient-level data available for children with novel coronavirus disease (COVID-19). Therefore, there is an urgent need for an updated systematic literature review that analyzes individual children rather than aggregated data in broad age groups. METHODS: Six databases (MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, medRxiv) were searched for studies indexed from January 1 to May 15, 2020, with MeSH terms: children, pediatrics, COVID-19, SARS-CoV-2. 1241 records were identified, of which only unique papers in English with individual patient information and documented COVID-19 testing were included. This review of 22 eligible studies followed Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data guidelines. RESULTS: A total of 123 patients from five countries were identified. 46% were females. The median age was 5 years (IQR = 8). At presentation, 62% had a fever, 32% had a cough, 58% had a single symptom, and 21% were asymptomatic. Abnormal chest imaging was seen in 62% (65/105) of imaged and 76.9% (20/26) of asymptomatic children. A minority of children had elevated platelets, CRP, lactate dehydrogenase, and D-dimer. CONCLUSION: Data from this independent participant data systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom. IMPACT: This systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom. By using an independent participant data approach, this analysis underscores the challenge of diagnosing COVID-19 in pediatric patients due to the wide variety of symptoms and seemingly poor correlation of imaging findings with symptomatic disease. The data presented from individual patients from case series or cohort studies add more granularity to the current description of pediatric COVID-19.Fig. 1FLOWCHART OF THE STUDY SELECTION PROCESS FOR INDIVIDUAL PATIENT DATA EXTRACTION.: Study selection was done in accordance with the PRISMA IPD guidelines.Fig. 2TRENDS FOR PEDIATRIC COVID-19 PATIENTS BY AGE.: Heat map representing the proportion of patients with each presenting symptom (a), clinical sign (b), or abnormal lab values (c) compared to all patients of that age who had information available. Color code ranges from white (0%) to dark gray (100%). The diagonal line indicates that no patients of that age had information available.

Revisión sistemática

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Dermatological manifestations of the Coronavirus disease2019 in children: a systemic review

Revista Advances in Dermatology and Allergology
Año 2022
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 22 Estudios primarios 22 Estudios primarios (22 referencias)

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Oral manifestations of Covid-19-A literature review.

Autores Farid H , Khah M , Jamal S , Ghafoor R
Revista Reviews in medical virology
Año 2022
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 16 Estudios primarios 16 Estudios primarios (16 referencias)

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Initially, it was reported that coronavirus 2019 disease (Covid-19) affects respiratory, gastrointestinal and neurological systems, but the oral, olfactory and integumentary systems are also involved. This review discusses various oral manifestations of Covid-19 reported in the literature along with possible underlying mechanisms. The reported manifestations include taste impairment, oral mucosal changes (petechiae, ulcers, plaque-like lesions, reactivation of herpes simplex virus 1(HSV1), geographical tongue and desquamative gingivitis) and dry mouth. The prominent location for mucosal lesions are tongue, palate and labial mucosa. The exact pathogenesis of these oral symptoms is not known. Angiotensin-converting enzyme 2 (ACE2) cell receptors are expressed in abundance on oral mucosa allowing severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) to infect them. Gustatory impairment along with olfactory changes is now listed as a symptom of Covid-19 by the World Health Organization, but further research is needed to confirm a link between reported additional oral symptoms and Covid-19. Dental professionals may encounter individuals with Covid-19 and be called upon to identify various oral manifestations of this disease.

Revisión sistemática

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The differential impact of pediatric COVID-19 between high-income countries and low- and middle-income countries: A systematic review of fatality and ICU admission in children worldwide.

Revista PloS one
Año 2021
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 416 Estudios primarios 415 Estudios primarios (416 referencias)

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BACKGROUND: The overall global impact of COVID-19 in children and regional variability in pediatric outcomes are presently unknown. METHODS: To evaluate the magnitude of global COVID-19 death and intensive care unit (ICU) admission in children aged 0-19 years, a systematic review was conducted for articles and national reports as of December 7, 2020. This systematic review is registered with PROSPERO (registration number: CRD42020179696). RESULTS: We reviewed 16,027 articles as well as 225 national reports from 216 countries. Among the 3,788 global pediatric COVID-19 deaths, 3,394 (91.5%) deaths were reported from low- and middle-income countries (LMIC), while 83.5% of pediatric population from all included countries were from LMIC. The pediatric deaths/1,000,000 children and case fatality rate (CFR) were significantly higher in LMIC than in high-income countries (HIC) (2.77 in LMIC vs 1.32 in HIC; p < 0.001 and 0.24% in LMIC vs 0.01% in HIC; p < 0.001, respectively). The ICU admission/1,000,000 children was 18.80 and 1.48 in HIC and LMIC, respectively (p < 0.001). The highest deaths/1,000,000 children and CFR were in infants < 1 year old (10.03 and 0.58% in the world, 5.39 and 0.07% in HIC and 10.98 and 1.30% in LMIC, respectively). CONCLUSIONS: The study highlights that there may be a larger impact of pediatric COVID-19 fatality in LMICs compared to HICs.

Revisión sistemática

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Multisystem Inflammatory Syndrome in Children (MISC): a systematic review.

Revista International journal of clinical practice
Año 2021
Enlaces Pubmed DOI

Este artículo incluye 32 Estudios primarios 32 Estudios primarios (32 referencias)

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OBJECTIVE: Analyze current literature and reported cases of MISC, concerning its clinical spectrum, complications associated, therapeutic strategies and distinguishing features of other clinical syndromes. METHODS: Extensive literature research was performed in MEDLINE (trough PubMed), Scopus and Web of Science from December 2019 to December 2020. First analysis included all article titles and abstracts screening to identify relevant studies and second analysis included a full text screening of previous selected studies. Eligibility was assessed independently by two authors and disagreements were resolved by discussion and consensus. Data were extracted on MISC definition, demographic data, clinical features, diagnostic tests, laboratory analysis and imaging, therapeutical approach and outcomes. RESULTS: Common symptoms included: gastrointestinal (70%), rash (57%) and cardiovascular (52% with shock). Notable differences with Kawasaki Disease were identified including age, clinical presentation and cardiac involvement. 30% presented positive SARS-CoV-2 2 reverse transcription polymerase chain reaction and 51% positive serologies. 62% received intravenous immunoglobulin and 42% glucocorticoids. 62% required intensive care, 21 children died (<2%). Severe presentations were associated with neurological symptoms, hepatitis and acute kidney injury. CONCLUSIONS: MISC raises concern on its severe cardiac involvement at presentation, with frequent intensive care and immunomodulatory therapy need. Short term outcomes seem to be favorable, with cardiac disfunction recovery and low mortality rates.

Revisión sistemática

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COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis

Revista Pediatric pulmonology
Año 2021
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 27 Estudios primarios 25 Estudios primarios (27 referencias)

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A systematic review of dermatologic manifestations among adult patients with COVID-19 diagnosis

Revista Skin health and disease
Año 2021
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 20 Estudios primarios 20 Estudios primarios (20 referencias)

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Abstract Background Infection with COVID-19 is characterized by respiratory, gastrointestinal and neurologic symptoms However, limited evidence exists of the involvement of the integumentary system among COVID-19 patients and evidence suggests that these symptoms may even be the first presenting sign Objective To systematically evaluate the literature published on dermatologic signs of COVID-19 in order to educate doctors about the dermatologic signs of COVID-19 infection Methods Lit COVID, World Health Organization COVID-19 database and PubMed were searched using terminology to identify adult patients with confirmed COVID-19 infection and dermatologic manifestations of disease The last search was completed on 13 July 2020 Results There were 802 reports found After exclusion, 20 articles were found with 347 patients with confirmed COVID-19 infection Within these articles, 27 different skin signs were reported Limitations Limitations of this review include the recency of COVID-19 infection;so, there are limited published reports and that many reports are not by dermatologists, and so, the cutaneous signs may be misdiagnosed or misdescribed Conclusion Dermatologic manifestations of COVID-19 may be the first presenting sign of infection;so, dermatologists and doctors examining the skin should be aware of the virus's influence on the integumentary system in order to promptly diagnose and treat the infected patients

Revisión sistemática

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Multisystem inflammatory syndrome in pediatric COVID-19 patients: a meta-analysis.

Revista World journal of pediatrics : WJP
Año 2021
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 15 Estudios primarios 14 Estudios primarios (15 referencias)

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BACKGROUND: We aimed to systematically review the clinical and laboratory features of patients with the multisystem inflammatory syndrome in pediatrics diagnosed during the COVID-19 pandemic. DATA SOURCES: A literature search in Web of Science, PubMed, Scopus, and Science Direct was made up to June 29, 2020. RESULTS: Analysis of 15 articles (318 COVID-19 patients) revealed that although many patients presented with the typical multisystem inflammatory syndrome in pediatrics, Kawasaki-like features as fever (82.4%), polymorphous maculopapular exanthema (63.7%), oral mucosal changes (58.1%), conjunctival injections (56.0%), edematous extremities (40.7%), and cervical lymphadenopathy (28.5%), atypical gastrointestinal (79.4%) and neurocognitive symptoms (31.8%) were also common. They had elevated serum lactic acid dehydrogenase, D-dimer, C-reactive protein, procalcitonin, interleukin-6, troponin I levels, and lymphopenia. Nearly 77.0% developed hypotension, and 68.1% went into shock, while 41.1% had acute kidney injury. Intensive care was needed in 73.7% of cases; 13.2% were intubated, and 37.9% required mechanical ventilation. Intravenous immunoglobulins and steroids were given in 87.7% and 56.9% of the patients, respectively, and anticoagulants were utilized in 67.0%. Pediatric patients were discharged after a hospital stay of 6.77 days on average (95% CI 4.93-8.6). CONCLUSIONS: Recognizing the typical and atypical presentation of the multisystem inflammatory syndrome in pediatric COVID-19 patients has important implications in identifying children at risk. Monitoring cardiac and renal decompensation and early interventions in patients with multisystem inflammatory syndrome is critical to prevent further morbidity.

Revisión sistemática

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Multisystem inflammatory syndrome in children related to COVID-19: a systematic review.

Revista European journal of pediatrics
Año 2021
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 68 Estudios primarios 66 Estudios primarios (68 referencias)

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An association between a novel pediatric hyperinflammatory condition and SARS-CoV-2 was recently published and termed pediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome (in children) (MIS(-C)). We performed a systematic review and describe the epidemiological, clinical, and prognostic characteristics of 953 PIMS-TS/MIS(-C) cases in 68 records. Additionally, we studied the sensitivity of different case definitions that are currently applied. PIMS-TS/MIS(-C) presents at a median age of 8 years. Epidemiological enrichment for males (58.9%) and ethnic minorities (37.0% Black) is present. Apart from obesity (25.3%), comorbidities are rare. PIMS-TS/MIS(-C) is characterized by fever (99.4%), gastrointestinal (85.6%) and cardiocirculatory manifestations (79.3%), and increased inflammatory biomarkers. Nevertheless, 50.3% present respiratory symptoms as well. Over half of patients (56.3%) present with shock. The majority of the patients (73.3%) need intensive care treatment, including extracorporal membrane oxygenation (ECMO) in 3.8%. Despite severe disease, mortality is rather low (1.9%). Of the currently used case definitions, the WHO definition is preferred, as it is more precise, while encompassing most cases.Conclusion: PIMS-TS/MIS(-C) is a severe, heterogeneous disease with epidemiological enrichment for males, adolescents, and racial and ethnic minorities. However, mortality rate is low and short-term outcome favorable. Long-term follow-up of chronic complications and additional clinical research to elucidate the underlying pathogenesis is crucial. What is Known: • A novel pediatric inflammatory syndrome with multisystem involvement has been described in association with SARS-CoV-2. • To date, the scattered reporting of cases and use of different case definitions provides insufficient insight in the full clinical spectrum, epidemiological and immunological features, and prognosis. What is New: • This systematic review illustrates the heterogeneous spectrum of PIMS-TS/MIS(-C) and its epidemiological enrichment for males, adolescents, and racial and ethnic minorities. • Despite its severe presentation, overall short-term outcome is good. • The WHO MIS definition is preferred, as it is more precise, while encompassing most cases.

Revisión sistemática

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What can the neurological manifestations of COVID-19 tell us : a meta-analysis

Autores He Y , Bai X , Zhu T , Huang J , Zhang H
Pre-print ResearchSquare
Año 2021
Enlaces DOI

Este artículo incluye 61 Estudios primarios 61 Estudios primarios (61 referencias)

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Background Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aim to gather and discuss COVID-19 various neurological symptoms of infection, and to assess the prevalence of each of the nervous system symptoms, and characterized by neurological in-depth discussions of nervous system damage mechanism, biomarkers and inspection methods, recovery and prognosis, and provide the research behind the potential target and direction. Methods We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020 to November 20, 2020 in Pubmed, Embase, and Cochrane library.The keywords used were COVID-19 and terminology related to nervous system performance.All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data was then collected for meta-analysis using a random-effects model. Results A total of 62 articles (n =32729) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were altered mental status (39% ; 95% CI 0.17-0.64 ; I 2 98.59%), encephalopathy (37% ; 95% CI 0.17-0.60 ; I 2 97.36%), myalgia(31% ; 95% CI 0.25-0.38; I 2 98.79%), headache(30% ; 95% CI 0.22-0.37; I 2 99.28%), smell impairment(28% ; 95% CI 99.57% ; I 2 0.17-0.39), taste dysfunction (27% ; 95% CI 0.18 -0.38 ; I 2 99.35%), acute ischemic stroke (23% ; 95% CI 0.06-0.47 ; I 2 99.30%), alteration of consciousness(17% ; 95% CI 0.06-0.31 ; I 2 96.78%), dizziness (10% ; 95% CI 0.06-0.15; I 2 95.30%), intracerebral haemorrhage (7% ; 95% CI 0.02-0.14 ; I 2 93.64%), vision impairment(5% ; 95% CI 0.02-0.10 ; I 2 92.73%), seizure(2% ; 95% CI 0.01-0.04 ; I 2 84.67%). Conclusions Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, so as to detect and treat early neurological complications of COVID-19 and reduce mortality.