Novel coronavirus infection (COVID‐19) in children younger than one year: A systematic review of symptoms, management and outcomes

• Published in: Acta Paediatrica Vol. 109; no. 10; pp. 1948 - 1955
• Main Authors: Raba, Ali Ahmed, Abobaker, Anis, Elgenaidi, Ismail Suliman, Daoud, Ahmed
• Format: Journal Article
• Language: English
• Published: Norway Wiley Subscription Services, Inc 01-10-2020; John Wiley and Sons Inc
• Subjects: Case reports; Children; clinical characteristics; Coronaviruses; Cough; COVID-19; COVID-19 - blood; COVID-19 - epidemiology; COVID-19 - therapy; Cross-sectional studies; Fever; Humans; Infant; Infant, Newborn; Infants; Literature reviews; Morbidity; Mortality; Neonates; novel coronavirus; outcomes; Review; Systematic review; novel coronavirus; infants; neonates; outcomes; clinical characteristics
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.15422

Aim
The aim of this systematic review was to evaluate the clinical characteristics of COVID‐19 in neonates and children under one year of age.
Methods
A systematic literature review of the MEDLINE, PubMed, CINAHL, Embase and EBSCO databases was carried out for studies from January 1, 2020, to April 7, 2020. We included all papers that addressed clinical manifestations, laboratory results, imaging findings and outcomes in infants and neonates.
Results
Our search identified 77 peer‐reviewed papers, and 18 papers covering 160 infants were reviewed. One paper was from Vietnam, and the other 17 were from China: eight were cross‐sectional studies, eight were case reports, one was a case series, and one was a prospective cohort study. The most common clinical symptoms were fever (54%) and cough (33%). Most infants were treated symptomatically, with frequent use of various empirical medications. Infants and neonates tended to have more severe COVID‐19 disease than older children: 11 (7%) were admitted to intensive care and one infant died. The mortality rate was 0.006%, with favourable outcomes in most cases.
Conclusion
Infants and neonates were more vulnerable to more severe COVID‐19 disease than older children, but morbidity and mortality were low.