Random-effects meta-analysis was undertaken. Quality was assessed using a critical appraisal checklist for prevalence studies. Single-household studies were excluded.ĭata Extraction and Synthesis PRISMA guidelines for abstracting data were followed, which was performed independently by 2 reviewers. Study Selection Studies that provided data on the prevalence of SARS-CoV-2 in children and adolescents (younger than 20 years) compared with adults (20 years and older) derived from contact tracing or population screening were included. Objective To systematically review the susceptibility to and transmission of SARS-CoV-2 among children and adolescents compared with adults.ĭata Sources PubMed and medRxiv were searched from database inception to July 28, 2020, and a total of 13 926 studies were identified, with additional studies identified through hand searching of cited references and professional contacts. The role of children and adolescents in transmission of SARS-CoV-2 is dependent on susceptibility, symptoms, viral load, social contact patterns, and behavior. Importance The degree to which children and adolescents are infected by and transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Zhao et al reported that in their cohort of 401 patients (positive on pharyngeal swabs), rectal swab positivity was 17% in those aged 18 years and over, but a much higher 57% in paediatric patients ( < 18 years) (4) Li et al found that in their cohort of 10 asymptomatic children that rectal swabs were positive in 8 of them and rectal swab positivity persisted beyond pharyngeal swabs in all 8 (3). GI Covid-19 may present with very mild symptoms or without symptoms, similar to how betacoronavirus infections exist in bats. Young children have a higher incidence of diarrhoea with Covid-19 (2) and there have been very few studies scrutinising the value of rectal swabs outside of severe disease cohorts. Gastrointestinal (GI) cases of Covid-19 may be escaping detection. Pharyngeal swabs may capture the vast majority of infections involving the respiratory tract but will not necessarily capture infections that follow ingestion of the virus. Shared Decision Making and CommunicationĪ possible source of bias is the reliance on pharyngeal swabs to establish diagnosis of Covid-19.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.

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