A 26-country review compiled from 131 studies, the largest systematic review to date of children and young adults with COVID-19, has found that majority of children with COVID-19 fared well clinically compared to adults during the first four months of the pandemic.

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While 19 percent of the pediatric population with COVID-19 had no symptoms, 21 percent exhibited patchy lesions on lung X-rays. "Nearly 5.6 percent suffered from co-infections, such as flu, on top of COVID-19, 3.3 percent were admitted to intensive care units and 7 deaths were reported," according to researchers from the Long School of Medicine at The University of Texas Health Science Center at San Antonio.

"Our data is compiled from 131 studies and encompasses 7,780 patients who span the pediatric age spectrum," said study senior author Alvaro Moreira, assistant professor of pediatrics at UT Health San Antonio. "Furthermore, we summarize treatments that were administered and offer an initial glimpse of a handful of patients who met the U.S. Centers for Disease Control and Prevention (CDC) criteria for multisystem inflammatory syndrome in children," said Moreira in the study appeared in EClinicalMedicine, a journal of The Lancet.

The most frequent symptoms among kids, similar to the adult population, were fever and cough. Those were found in 59 percent and 56 percent of the pediatric population. The number of children with excellent outcomes surprised the research team. "Although we are hearing about severe forms of the disease in children, this is occurring in very rare circumstances," said Moreira.

Laboratory measures that were consistently abnormal in pediatric COVID-19 patients included inflammatory markers such as creatine kinase, interleukin-6 and procalcitonin. Thankfully, only a small number of patients met inclusion for multisystem inflammatory syndrome in children. Their disease paralleled the extreme forms of COVID-19 seen in adults. "Children with systemic inflammation had a significant decrease in the amount of lymphocytes in their blood,: informed Moreira. "COVID-positive children who didn't have the extreme form of the disease had 42 percent lymphocytes in their blood, versus 11 percent in children with the multisystem syndrome".

Lymphocytes are one of the main types of immune cells in the body. Kidney failure was seen in nine pediatric patients, liver failure also in nine and shock in 19. Mechanical ventilation was required by 42 patients, the authors wrote.