SARS-CoV-2 (COVID-19): What Do We Know about Children? A Systematic Review

Nisha S. Mehta*, Oliver T. Mytton, Edward W.S. Mullins, Tom A. Fowler, Catherine L. Falconer, Orla B. Murphy, Claudia Langenberg, Wikum J.P. Jayatunga, Danielle H. Eddy, Jonathan Nguyen-van-Tam

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

109 Citations (Scopus)


Background: Few pediatric cases of coronavirus disease 2019 (COVID-19) have been reported and we know little about the epidemiology in children, although more is known about other coronaviruses. We aimed to understand the infection rate, clinical presentation, clinical outcomes, and transmission dynamics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in order to inform clinical and public health measures. Methods: We undertook a rapid systematic review and narrative synthesis of all literature relating to SARS-CoV-2 in pediatric populations. The search terms also included SARS-CoV and MERS-CoV. We searched 3 databases and the COVID-19 resource centers of 11 major journals and publishers. English abstracts of Chinese-language papers were included. Data were extracted and narrative syntheses conducted. Results: Twenty-four studies relating to COVID-19 were included in the review. Children appear to be less affected by COVID-19 than adults by observed rate of cases in large epidemiological studies. Limited data on attack rate indicate that children are just as susceptible to infection. Data on clinical outcomes are scarce but include several reports of asymptomatic infection and a milder course of disease in young children, although radiological abnormalities are noted. Severe cases are not reported in detail and there are few data relating to transmission. Conclusions: Children appear to have a low observed case rate of COVID-19 but may have rates similar to adults of infection with SARS-CoV-2. This discrepancy may be because children are asymptomatic or too mildly infected to draw medical attention and be tested and counted in observed cases of COVID-19.

Original languageEnglish
Pages (from-to)2469-2479
Number of pages11
JournalClinical Infectious Diseases
Issue number9
Publication statusPublished - 1 Nov 2020

Bibliographical note

Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.


  • children
  • coronavirus
  • COVID-19
  • infection
  • SARS-CoV-2


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