Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10516-10528
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10516
Comparison of laboratory parameters, clinical symptoms and clinical outcomes of COVID-19 and influenza in pediatric patients: A systematic review and meta-analysis
Bang Yu, Hai-Hua Chen, Xiao-Fei Hu, Rui-Zhi Mai, Hai-Yan He
Bang Yu, Hai-Hua Chen, Xiao-Fei Hu, Rui-Zhi Mai, Hai-Yan He, Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
Author contributions: Yu B and Chen HH conceived and designed the study; Chen HH, Hu XF, Mai RZ and He HY collected the data and performed the analysis; Yu B was involved in the writing of the manuscript and is responsible for the integrity of the study; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The review was reported according to the PRISMA statement 2020.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Bang Yu, PhD, Research Scientist, Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, No. 308 Huilongguan East Main Street, Changping District, Beijing 102200, China.
Received: May 16, 2022
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
Research background

Patients in the pediatric age group are primary carriers of the influenza virus and are at a higher risk of developing severe infection. However, studies, comparing influenza and coronavirus disease 2019 (COVID-19) to show which condition causes a more severe form of disease amongst the pediatric age group, are scarce. This study aims to compare the laboratory results, clinical symptoms and clinical outcomes in pediatric patients with COVID-19 and influenza.

Research motivation

To the best of our knowledge, there are no pooled data on the difference in laboratory results, clinical symptoms and clinical outcomes between COVID-19 and influenza patients of this age group.

Research objectives

The purpose of the present review is to pool data from individual studies to examine the possible differences in laboratory results, clinical symptoms and clinical outcomes between pediatric COVID-19 and influenza patients.

Research methods

A comprehensive search in the databases such as EMBASE, Cochrane library, MEDLINE, and search engines like Google Scholar and ScienceDirect was carried out. The following filters were applied during the search: time point [January 1964 (inception of Medline database) to January 2022], language (English only), and design (observational study).

Research results

Pediatric COVID-19 patients had a significantly reduced risk of cough [pooled odds ratio (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 standardized mean difference = 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.

Research conclusions

COVID-19 is associated with a significantly lower rate of clinical symptoms and abnormal laboratory indexes compared to influenza in the pediatric age group.

Research perspectives

Further longitudinal studies of the outcomes between influenza and COVID-19 pediatric patients are needed.