TY - JOUR
T1 - The differential impact of pediatric COVID-19 between high-income countries and low- and middle-income countries: A systematic review of fatality and ICU admission in children worldwide
AU - Kitano, Taito
AU - Kitano, Mao
AU - Krueger, Carsten
AU - Jamal, Hassan
AU - Al Rawahi, Hatem
AU - Lee-Krueger, Rachelle
AU - Sun, Rose Doulin
AU - Isabel, Sandra
AU - García-Ascaso, Marta Taida
AU - Hibino, Hiromi
AU - Camara, Bettina
AU - Isabel, Marc
AU - Cho, Leanna
AU - Groves, Helen E.
AU - Piché-Renaud, Pierre Philippe
AU - Kossov, Michael
AU - Kou, Ikuho
AU - Jon, Ilsu
AU - Blanchard, Ana C.
AU - Matsuda, Nao
AU - Mahood, Quenby
AU - Wadhwa, Anupma
AU - Bitnun, Ari
AU - Morris, Shaun K.
N1 - Publisher Copyright:
Copyright: © 2021 Kitano et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/1/29
Y1 - 2021/1/29
N2 - Background: The overall global impact of COVID-19 in children and regional variability in pediatric outcomes are presently unknown. Methods: To evaluate the magnitude of global COVID-19 death and intensive care unit (ICU) admission in children aged 0-19 years, a systematic review was conducted for articles and national reports as of December 7, 2020. This systematic review is registered with PROSPERO (registration number: CRD42020179696). Results: We reviewed 16,027 articles as well as 225 national reports from 216 countries. Among the 3,788 global pediatric COVID-19 deaths, 3,394 (91.5%) deaths were reported from low- and middle-income countries (LMIC), while 83.5% of pediatric population from all included countries were from LMIC. The pediatric deaths/1,000,000 children and case fatality rate (CFR) were significantly higher in LMIC than in high-income countries (HIC) (2.77 in LMIC vs 1.32 in HIC; p < 0.001 and 0.24% in LMIC vs 0.01% in HIC; p < 0.001, respectively). The ICU admission/1,000,000 children was 18.80 and 1.48 in HIC and LMIC, respectively (p < 0.001). The highest deaths/1,000,000 children and CFR were in infants < 1 year old (10.03 and 0.58% in the world, 5.39 and 0.07% in HIC and 10.98 and 1.30% in LMIC, respectively). Conclusions: The study highlights that there may be a larger impact of pediatric COVID-19 fatality in LMICs compared to HICs.
AB - Background: The overall global impact of COVID-19 in children and regional variability in pediatric outcomes are presently unknown. Methods: To evaluate the magnitude of global COVID-19 death and intensive care unit (ICU) admission in children aged 0-19 years, a systematic review was conducted for articles and national reports as of December 7, 2020. This systematic review is registered with PROSPERO (registration number: CRD42020179696). Results: We reviewed 16,027 articles as well as 225 national reports from 216 countries. Among the 3,788 global pediatric COVID-19 deaths, 3,394 (91.5%) deaths were reported from low- and middle-income countries (LMIC), while 83.5% of pediatric population from all included countries were from LMIC. The pediatric deaths/1,000,000 children and case fatality rate (CFR) were significantly higher in LMIC than in high-income countries (HIC) (2.77 in LMIC vs 1.32 in HIC; p < 0.001 and 0.24% in LMIC vs 0.01% in HIC; p < 0.001, respectively). The ICU admission/1,000,000 children was 18.80 and 1.48 in HIC and LMIC, respectively (p < 0.001). The highest deaths/1,000,000 children and CFR were in infants < 1 year old (10.03 and 0.58% in the world, 5.39 and 0.07% in HIC and 10.98 and 1.30% in LMIC, respectively). Conclusions: The study highlights that there may be a larger impact of pediatric COVID-19 fatality in LMICs compared to HICs.
U2 - 10.1371/journal.pone.0246326
DO - 10.1371/journal.pone.0246326
M3 - Article
C2 - 33513204
AN - SCOPUS:85100309325
SN - 1932-6203
VL - 16
JO - PLOS ONE
JF - PLOS ONE
IS - 1
M1 - e0246326
ER -