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An evidence summary of Paediatric COVID-19 literature

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This post is a rapid literature review of pertinent paediatric literature regarding COVID-19 disease. We are proud to have joined forces with the UK Royal College of Paediatrics and Child Health to provide systematic search, and selected reviews of all the COVID-19 literature relevant to children and young people.

Our search and review methods have changed as the pace and utility of the published literature has evolved over time. Our process involved a formal literature search (methods can be found here), followed by identification of all papers relevant to children/young people, then reading of every article by one of our team of doctors. Initially we produced a written review of all publications, however on April 17th 2020 we moved to a more selective review process. All articles were read in full, then if high enough quality, determined by consensus and involvement of a clinical academic, a written review was also produced.

As of June 30th 2020, we have again revised our process as the urgent need for rapid evidence synthesis has lessened, and the volume of research published remains extremely high, with much of it adding little to the current body of knowledge. Our search criteria has therefore narrowed, and of the articles identified as relevant, only those felt to be of exceptional quality or impact (as determined by consensus with involvement of a clinical academic) are selected for written review.

Our team of reviewers includes Alasdair Munro, Alison Boast, Henry Goldstein, Grace Leo, Dani Hall, Daniel Yeoh, Tessa Davis, Melody Redman, Sarah Sloan, Tricia Barlow, Anne Bean, Maeve Kelleher, Victoria Dachtler, Irnthu Premadeva, Lilian Nyirongo, Esther Alderson, Sunil Bhopal, Aimee Donald and Rachel Harwood.

Here we present the top 10 papers from each category (Paediatric clinical cases, Epidemiology and transmission, and Neonates). At the top is an Executive summary followed by all New and noteworthy studies.

If you have feedback please email us at hello@dontforgetthebubbles.com

Executive Summary (Updated 21st January 2021)

New and Noteworthy (Updated 11 April 2021)

Top 10 Neonatal Papers

Top 10 Clinical Papers

Top Papers on Co-morbidities

Top 10 Epidemiological Papers on Transmission

Top Epidemiological Papers on Disease Burden

Top 10 PIMS-TS / MIS-C Papers

paediatric-covid-data

First authorLast authorJournalArticle titleDate of PublicationCountryRegion(n) childrenStudy typePaper linkReview

paediatric-covid-data

First authorLast authorJournalArticle titleDate of PublicationCountryRegion(n) childrenStudy typePaper linkReview

Author

  • Alison is a paediatric registrar in Australia, currently embarking on her PhD in bone and joint infections. She is passionate about teaching and making the world just that little bit more organized with the help of washi tape. Alasdair is a Paediatric registrar in the UK, currently working as a Clinical Research Fellow in Paediatric Infectious Diseases. His interests include evidence based medicine, diagnostics and antimicrobial resistance. Henry is a paediatric trainee based in Queensland, Australia, Henry is passionate about Adolescent Medicine & General Paediatrics, with a strong interest in Medical Education & Clinical Teaching. An admitted nerd & ironman with a penchant for Rubik's Cubes & 'Dad jokes'.

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61 thoughts on “An evidence summary of Paediatric COVID-19 literature”

  1. “Our search criteria […]only those felt to be of exceptional quality”

    Selection criteria, based on feelings ?

    Sorry this cannot be taken as a serious meta study which must be based on objective selection criteria.
    No wonder, all selected studies fit a single narrative: “open the schools”.

  2. Has there been anything said about that the children are not going out so wouldn’t be the primary source of the disease (adults doing food shop)? Also, they would rarely be the care giver if a member of household became ill, so less chance of transmission there too.

  3. Dear Alison, Alasdair and Henry, I´ve been following your updates for weeks now. Very helpful. Great work, very much appreciated! Way to go!

  4. Dear Alison, Alasdair and Henry, I was looking for a nice summary of pediatrics literatures and I found yours to be very comprehensive and well organized. Thank you so much!

  5. Pratik Patel M.D.

    Dear Don’t Forget the Bubbles,

    I wanted to make you aware of a critically ill previously healthy pediatric patient who we had in Atlanta (USA) in late March who had concern for hyperinflammation and was successfully treated with a variety of COVID as well as hyperinflammation treatments (remdesivir and tocilizumab). We published our case and it is available online at Pediatrics in case you were interested in including it in your future summaries/posts! https://pediatrics.aappublications.org/content/pediatrics/early/2020/04/30/peds.2020-1437.full.pdf

    Thanks,
    Pratik

  6. Cui Y, Tian M, Huang D, et al. A 55-Day-Old Female Infant infected with COVID 19: presenting with pneumonia, liver injury, and heart damage. J Infect Dis
    Concerning the elevated troponin: we see a slightly elevated troponin in all our young babies (newborn and older), without any clinical or echographic signs of cardiac involvement

  7. Thanks for this wonderful tool. Just one important remark? If you sort according to the date of publication, it is no in a chronological order. It might work if you put the year first, than the month and than the day.
    Best, Tilmann

  8. Dr Luke Jeremijenko Emergency Physician

    Thanks team. Wonderful resource. Avidly reading through the papers. Question to the DFTB brains trust. I ran Dr Ben Symons simulation today and was asked (appropriately) is there a viral filter available for the F&P airvo 2? How are people running HFNP outside a negative pressure room?

    1. We are trying to see what the evidence is, or at least find some expert consensus on this, so watch this space. I’m not a fan of the idea at the moment so we are advocating for starting it in the place it is going to b ultimately used. You don’t want to push a patient on HF through the hospita.l

  9. Kgomotso Lovey Sanyane

    What a wonderful post. Absolutely valuable information in these trying times. I’m a paediatrician in South Africa and we are experiencing an increasing amount of COVID-19 cases

  10. Paeds medical nurse practitioner here, amazing job on the delivery of such valuable information. Great work. Your time & effort greatly appreciated.

  11. Thank you so much for putting this together. Great Work. Faecal shedding is interesting and worrysome at the same time

  12. Thank you for reviewing these papers a friend who is a
    Paediatric nurse sent me this information. What is interesting is that a lot of studies note fecal shedding of virus or detection of virus in fecal samples is still there after oral/nasal tests are negative for virus. This is interesting as it seems coronavirus have evolved and originated in bats and bats shed these virus in fecal matter.

  13. Thank you. As a paediatric anaesthetist I’m trying to keep up with all the latest information and this is a great summary and am very grateful you’ve done this review.

  14. Dear DFTB Team, thank you for this very helpful summary!

    Please note: In Cui Y, Tian M, Huang D, et al. , A 55- day old female.. the authors write at the end of the first paragraph:
    “The nasopharyngeal swab obtained from the infant also tested positive for severe acute respiratory syndrome coronavirus (SARS-CoV-2) on real-time reverse transcription–polymerase-chain-reaction (RT-PCR) assay.”
    I find this reassuring and would like to recommend to correct this part of your summary.
    Sincerely, Angela

    1. Thank you for pointing out this omission – we will correct this immediately. We appreciate you taking the time to comment and help us improve the post.

  15. Good to know COVID in kids is relatively mild. However, do we know anything about numbers of paediatric HCWs becoming infected?

  16. Thank you so much . This is a great summary , and such a positive look at paediatric covid cases , so we can somehow reassure the panicked mothers!

  17. Thanks a lot for doing this excellent work. These data are confirmed in Italy. Up to Now few children admittedto the hospital, mild symptoms, NO admission di intensive care. Keep fingers crossed. Very important to apply prevention policy and . isolation. Infection rate is starting to decrease in the area where the isolation was perforned rigorously (North East of Italy meaning Veneto and Friuli Venezia Giulia where I work. Good luck to all of you and keep safe

  18. thank you – interesting that they have unilateral opacities on some CXR considering all I knew previously was that it was bilateral ground glass – makes me wonder about the kid I sent home recently with coamox as the XR changes were unilateral…however he has not come back so I assume he is ok! no harm, no foul.

  19. With Mycoplasms noted more than just once do Symptomatic cases earn Azithromycin or other atypical therapy while waiting for results? Would the CXR / CT chest findings be consistent with Mycoplasms?

  20. This is amazing – thanks!! Paeds Reg on mat leave with a newborn here. Have been wanting to look into this but too tired to tackle – I am so appreciative.

  21. We need risk and recommendation commentary on special needs paediatric population; particularly those of school age (and whose parents/Carers are front line such as health care workers)

    1. Echoing your request; this cohort needs timely guidance based on what evidence we can glean. Thanks DFTB once again for educational content.

    2. I am a NHS front line worker with a child who has severe & complex needs and recurring chest infections. Currently isolated pseudomonas in the chest. Desperate for information.

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