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Most children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have mild respiratory symptoms or are asymptomatic, according to a review published online April 22 in JAMA Pediatrics.

Riccardo Castagnoli, M.D., from the Fondazione IRCCS Policlinico San Matteo in Pavia, Italy, and colleagues conducted an extensive search to review all articles published from Dec. 1, 2019, to March 3, 2020, to evaluate currently reported pediatric cases of SARS-CoV-2 infection. Eight hundred fifteen articles were identified; the final analysis included 18 articles with 1,065 participants with confirmed SARS-CoV-2 infection.

The researchers found that children at any age were mostly reported to be asymptomatic or had mild respiratory symptoms, including fever, dry cough, and fatigue. The main radiologic features were bronchial thickening and ground-glass opacities; these findings were also reported in asymptomatic patients. Only one case of severe COVID-19 infection was reported in the included articles; this case occurred in a 13-month-old infant. Among children aged 0 to 9 years, there were no deaths reported. Limited data were available regarding therapies.

"The quick worldwide spread of SARS-CoV-2 infection and the lack of European and U.S. data on pediatric patients require further epidemiologic and clinical studies to identify possible preventive and therapeutic strategies," the authors write.