Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10516
Peer-review started: May 16, 2022
First decision: July 13, 2022
Revised: July 26, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: October 16, 2022
New and more severe clinical manifestations associated with the coronavirus disease 2019 (COVID-19) are emerging constantly in the pediatric age group. Patients in this age group are also primary carriers of the influenza virus and are at a higher risk of developing severe infection. However, studies comparing influenza and COVID-19 to show which condition causes a more severe form of disease amongst the pediatric age group are scarce.
To compare the laboratory results, clinical symptoms and clinical outcomes in pediatric patients with COVID-19 and influenza.
A systematic and comprehensive search was carried out in databases and search engines, including EMBASE, Cochrane, MEDLINE, ScienceDirect and Google Scholar from 1964 until January 2022. A meta-analysis was carried out using a random-effects model and pooled odds ratio (OR) or standardized mean difference (SMD) and 95%CI.
A total of 16 studies satisfied the inclusion criteria. Pediatric COVID-19 patients had a significantly reduced risk of cough (pooled OR = 0.16; 95%CI: 0.09 to 0.27), fever (pooled OR = 0.23; 95%CI: 0.12 to 0.43), and dyspnea (pooled OR = 0.54; 95%CI: 0.33 to 0.88) compared to influenza patients. Furthermore, total hemoglobin levels (pooled SMD = 1.22; 95%CI: 0.29 to 2.14) in COVID-19 patients were significantly higher as compared to pediatric influenza patients. There was no significant difference in symptoms such as sore throat, white blood cell count, platelets, neutrophil and lymphocytes levels, and outcomes like mortality, intensive care unit admission, mechanical ventilation or length of hospital stay.
COVID-19 is associated with a significantly lower rate of clinical symptoms and abnormal laboratory indexes compared to influenza in the pediatric age group. However, further longitu
Core Tip: Developing new strategies for prevention, early diagnosis and adequate management of pediatric patients infected with coronavirus disease 2019 (COVID-19) or influenza is crucial. It is still not clear which of these two viruses is more severe in pediatric patients and requires intensive interventions. In addition, co-circulation of influenza and COVID-19 present certain diagnostic and therapeutic difficulties, given the similarities in the clinical features, and may lead to adverse treatment outcomes. Our review is the first attempt to compare the various clinical features, laboratory parameters and outcomes between COVID-19 and influenza pediatric patients. However, longitudinal evidence is required to identify reliable effect sizes and to make evidence-based recommendations for developing interventions in the hospital setting.