MU Bhuiyan
Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis
Bhuiyan, MU; Stiboy, Eunice; Hassan, MZ; Chan, Mei; Islam, MS; Haider, Najmul; Jaffe, Adam; Homaira, Nusrat
Authors
Eunice Stiboy
MZ Hassan
Mei Chan
MS Islam
Najmul Haider n.haider@keele.ac.uk
Adam Jaffe
Nusrat Homaira
Abstract
Introduction
Emerging evidence suggests young children are at greater risk of COVID-19 infection than initially predicted. However, a comprehensive understanding of epidemiology of COVID-19 infection in young children under five years, the most at-risk age-group for respiratory infections, remain unclear. We conducted a systematic review and meta-analysis of epidemiological and clinical characteristics of COVID-19 infection in children under five years.
Method
Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses , we searched several electronic databases (Pubmed, EMBASE, Web of Science, and Scopus) with no language restriction for published epidemiological studies and case-reports reporting laboratory-confirmed COVID-19 infection in children under five years until June 4, 2020. We assessed pooled prevalence for key demographics and clinical characteristics using Freeman-Tukey double arcsine random-effects model for studies except case-reports. We evaluated risk of bias separately for case-reports and other studies.
Results
We identified 1,964 articles, of which, 65 articles were eligible for systematic review that represented 1,214 children younger than five years with laboratory-confirmed COVID-19 infection. The pooled estimates showed that 50% young COVID-19 cases were infants (95% CI: 36% - 63%, 27 studies); 53% were male (95% CI: 41% - 65%, 24 studies); 43% were asymptomatic (95% CI: 15% - 73%, 9 studies) and 7% (95% CI: 0% - 30%, 5 studies) had severe disease that required intensive-care-unit admission. Of 139 newborns from COVID-19 infected mothers, five (3.6%) were COVID-19 positive. There was only one death recorded.
Discussion
This systematic review reports the largest number of children younger than five years with COVID-19 infection till date. Our meta-analysis shows nearly half of young COVID-19 cases were asymptomatic and half were infants, highlighting the need for ongoing surveillance to better understand the epidemiology, clinical pattern, and transmission of COVID-19 to develop effective preventive strategies against COVID-19 disease in young paediatric population.
Citation
Bhuiyan, M., Stiboy, E., Hassan, M., Chan, M., Islam, M., Haider, N., Jaffe, A., & Homaira, N. (2021). Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis. Vaccine, 39(4), 667 - 677. https://doi.org/10.1016/j.vaccine.2020.11.078
Journal Article Type | Article |
---|---|
Acceptance Date | Nov 30, 2020 |
Online Publication Date | Dec 5, 2020 |
Publication Date | 2021-01 |
Publicly Available Date | May 30, 2023 |
Journal | Vaccine |
Print ISSN | 0264-410X |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 39 |
Issue | 4 |
Pages | 667 - 677 |
DOI | https://doi.org/10.1016/j.vaccine.2020.11.078 |
Public URL | https://keele-repository.worktribe.com/output/424635 |
Publisher URL | https://www.sciencedirect.com/science/article/pii/S0264410X2031570X?via%3Dihub |
Files
2. 26. 2021. 1 Bhuiyan et al_Epidemiology-of-COVID-19-infection-in-young-children-under-five-ye_2021_Vacc.pdf
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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