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논문 기본 정보

자료유형
학술저널
저자정보
Jae Hong Choi (Jeju National University School of Medicine) Soo-Han Choi (Pusan National University Hospital) Ki Wook Yun (Seoul National University College of Medicine)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.37 No.5
발행연도
2022.2
수록면
1 - 14 (14page)
DOI
10.3346/jkms.2022.37.e35

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초록· 키워드

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Background: Coronavirus disease 2019 (COVID-19) has been the most important global issue since December 2019. Although the clinical course of COVID-19 is known to be milder in children than in adults, associated hospitalizations among children have increased since the emergence of contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and the achievement of a high vaccination rate in adults. Considering these global and domestic situations, we believe that risk stratification in children with COVID-19 is urgently needed for decision making regarding hospitalization priority in children infected with SARS-CoV-2 and vaccination priority against COVID-19. Methods: This systematic review and meta-analysis was performed by comprehensively searching the PubMed, EMBASE, Scopus and KoreaMed databases through August 25, 2021. The criteria for enrollment were “severe COVID-19” as poor outcomes (intensive care unit admission, invasive mechanical ventilation, and/or death) and underlying comorbidities before SARS-CoV-2 infection. Results: Among 872 screened studies, 17 articles were included in the systematic review, and 10 articles were included in the meta-analysis. Neonate (risk ratio [RR], 2.69; 95% confidence interval [CI], 1.83?3.97), prematurity in young infants (RR, 2.00; 95% CI, 1.63?2.46), obesity (RR, 1.43; 95% CI, 1.24?1.64), diabetes (RR, 2.26; 95% CI, 1.95?2.62), chronic lung disease (RR, 2.62; 95% CI, 1.71?4.00), heart disease (RR, 1.82; 95% CI, 1.58?2.09), neurologic disease (RR, 1.18; 95% CI, 1.05?1.33), and immunocompromised status (RR, 1.44; 95% CI, 1.01?2.04) were significant risk factors for severe COVID-19 in children. In the subgroup analysis, age younger than 3 months (RR, 0.26; 95% CI, 0.11?0.66), asthma (RR, 1.08; 95% CI, 0.98?1.20), and neurodevelopmental disorders (RR, 0.88; 95% CI, 0.75?1.04) were not risk factors for severe COVID-19. Conclusion: Children with comorbidities such as obesity, diabetes, heart disease, chronic lung diseases other than asthma, seizure disorders, and an immunocompromised status had a high prevalence of severe COVID-19. Neonate and premature infants had a high risk of severe COVID-19. Defining the high-risk group for severe COVID-19 could help to guide hospital admission and priority for vaccination against SARS-CoV-2.

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