PLoS ONE (Jan 2021)

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.

  • Taito Kitano,
  • Mao Kitano,
  • Carsten Krueger,
  • Hassan Jamal,
  • Hatem Al Rawahi,
  • Rachelle Lee-Krueger,
  • Rose Doulin Sun,
  • Sandra Isabel,
  • Marta Taida García-Ascaso,
  • Hiromi Hibino,
  • Bettina Camara,
  • Marc Isabel,
  • Leanna Cho,
  • Helen E Groves,
  • Pierre-Philippe Piché-Renaud,
  • Michael Kossov,
  • Ikuho Kou,
  • Ilsu Jon,
  • Ana C Blanchard,
  • Nao Matsuda,
  • Quenby Mahood,
  • Anupma Wadhwa,
  • Ari Bitnun,
  • Shaun K Morris

DOI
https://doi.org/10.1371/journal.pone.0246326
Journal volume & issue
Vol. 16, no. 1
p. e0246326

Abstract

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BackgroundThe overall global impact of COVID-19 in children and regional variability in pediatric outcomes are presently unknown.MethodsTo 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).ResultsWe 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 ConclusionsThe study highlights that there may be a larger impact of pediatric COVID-19 fatality in LMICs compared to HICs.