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.

Autor:	Kulkarni D; Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom., Ismail NF; Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom.; Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia., Zhu F; Schol of Public Health, Nanjing Medical University, China., Wang X; Schol of Public Health, Nanjing Medical University, China., Del Carmen Morales G; Pfizer, Vaccines, Emerging Markets., Srivastava A; Pfizer, Vaccines, Emerging Markets.; Orbital Therapeutics, USA., Allen KE; Pfizer, Vaccines, Emerging Markets., Spinardi J; Pfizer, Vaccines, Emerging Markets., Rahman AE; Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom.; International Centre for Diarrhoeal Diseases Research, Bangladesh., Kyaw MH; Pfizer, Vaccines, Emerging Markets., Nair H; Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom.; Schol of Public Health, Nanjing Medical University, China.; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Jazyk:	angličtina
Zdroj:	Journal of global health [J Glob Health] 2024 Mar 01; Vol. 14, pp. 05003. Date of Electronic Publication: 2024 Mar 01.
DOI:	10.7189/jogh.14.05003
Abstrakt:	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. Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose the following activities and/or relationships: DK reports consulting fees from Pfizer, related to the submitted work and outside the submitted work. XW received research grants from GlaxoSmithKline, Wellcome Trust, and Nanjing Medical University, outside the submitted work, and consultancy fees from Pfizer, related to the submitted work. AS, JS, and MHK are employees of Pfizer. AS was a Pfizer employee during study conduct and manuscript development and may hold stock options; he is currently employed by Orbital Therapeutics. HN reports consulting fees from Pfizer, related to the submitted work; and grants from the Innovative Medicines Initiative outside the submitted work; consulting fees from the Gates Foundation, Pfizer, and Sanofi; honoraria from AbbVie; support from Sanofi for attending meetings; and participation on advisory boards from GSK, Merck, Pfizer, Sanofi, Icosavax, Janssen, Novavax, Reviral, Resvinet, and WHO outside the submitted work. (Copyright © 2024 by the Journal of Global Health. All rights reserved.)
Databáze:	MEDLINE
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