[논문]COVID-19 소아 환자의 임상 양상 및 실험실적 특징: 체계적문헌고찰 및 메타분석

윤하영; 조영아; 이정; 곽혜선; 한지민

doi:10.24304/kjcp.2020.30.4.270

[국내논문] COVID-19 소아 환자의 임상 양상 및 실험실적 특징: 체계적문헌고찰 및 메타분석
Clinical and Laboratory Features of Pediatric Patients with COVID-19: Systematic Review and Meta-analysis 원문보기

한국임상약학회지 = Korean journal of clinical pharmacy, v.30 no.4, 2020년, pp.270 - 278

윤하영 (이화여자대학교 약학대학) , 조영아 (경상대학교 약학대학) , 이정 (이화여자대학교 약학대학) , 곽혜선 (이화여자대학교 약학대학) , 한지민 (충북대학교 약학대학)

Abstract ▼ AI-Helper

Background: Although the identification of clinical and laboratory features in pediatric COVID-19 patients is essential in establishing an appropriate treatment plan, a systematic review and meta-analysis on the topic has yet to be reported. Methods: We searched MEDLINE, Embase, and Web of Science to access clinical and laboratory characteristics as well as clinical outcomes of children with COVID-19 infection. A meta-analysis using random-effect model was performed to estimate pooled prevalence and 95% confidence intervals. Results: Among the 532 studies initially collected, 12 articles were finally included in the meta-analysis. Among the investigated 320 pediatric patients with COVID-19, fever (48.2%) and cough (39.3%) were the most common symptoms. Almost one third of patients (30.4%) were asymptomatic. In laboratory findings, only 11.4% of pediatric patients experienced lymphocytopenia. Increased inflammatory markers including c-reactive protein (18.6%) and procalcitonin (32.4%) were observed. Only a few patients needed mechanical ventilation and intensive care support, and only one death was reported. Conclusion: Pediatric patients with COVID-19 infection exhibited milder symptoms and more favorable outcomes compared to adults. However, considering the high rate of asymptomatic pediatric patients, close monitoring is required to prevent community infection in asymptomatic conditions and hidden disease progression.

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제안 방법

consensus. The extracted information included the first author’s name, country, study duration, diagnostic method, number of reported cases, cases in the intensive care unit (ICU), age, sex, clinical characteristics including sign and symptoms, laboratory findings, severity, and clinical outcomes. The clinical characteristics included fever, cough, fatigue/myalgia, dyspnea/tachypnea, and no symptoms (asymptomatic).
However, the exceptional vulnerability of children to viral infections calls for the identification of clinical and laboratory features in pediatric COVID-19 patients for the improvement of childrenspecific diagnosis and treatment. This systematic review and meta-analysis was conducted to investigate the early pediatric characteristics of the COVID-19 outbreak before the mutation of the new strains.

대상 데이터

The clinical characteristics included fever, cough, fatigue/myalgia, dyspnea/tachypnea, and no symptoms (asymptomatic). The laboratory findings included lymphocytes, c-reactive protein (CRP) and procalcitonin (PCT). If the lymphocyte level was lower than 1.
After the removal of duplicates, 291 records were initially identified, and the titles and abstracts were screened under the inclusion criteria. From this initial review, full texts of 59 studies were assessed for eligibility. In the end, data on a total of 320 patients from 12 articles were investigated for this meta-analysis.
High PCT and CRP in pediatric COVID-19 patients were found in this study. Increased inflammatory markers including CRP and PCT were commonly reported laboratory values in children and adolescents with COVID-19.

이론/모형

¹⁰⁾ For meta-analyses, pooled prevalence and 95% confidence intervals (CIs) were estimated to summarize the weighted effect size for clinical, laboratory characteristics and clinical outcomes of children with COVID-19, and mean value and 95% CI were estimated for duration of hospitalization using a random-effect model. Publication bias was assessed using Egger’s regression test of the funnel plots. For measures of heterogeneity, I² statistics and τ²were calculated.
0; R Foundation for Statistical Computing, Vienna, Austria) meta packages. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.

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