Rev Med UAS
Vol. 11: No. 1. Enero-Marzo 2021
ISSN 2007-8013

Morbimortalidad de COVID-19 en comparación a Influenza en niños: revisión sistemática.

Morbidity and mortality of COVID-19 compared to Influenza in children: systematic review.

Daniel Eduardo Verdugo-Borbón1*, Andrea Mayorga-Inzunza2, Giordano Pérez-Gaxiola3*..

  1. Médico pasante de servicio social. Hospital Pediátrico de Sinaloa “Dr. Rigoberto Aguilar Pico”. Culiacán, México.
  2. Médico pasante de servicio social. Hospital Regional “Dr. Manuel Cárdenas De La Vega” I.S.S.S.T.E. Culiacán, México.
  3. Depto. de Medicina Basada en la Evidencia. Hospital Pediátrico de Sinaloa “Dr. Rigoberto Aguilar Pico”. Culiacán, México.

*Autor de correspondencia: Giordano Pérez-Gaxiola, giordano@pediatrica.org
Hospital Pediátrico de Sinaloa. Blvd. Constitución y Donato Guerra SN. Culiacán, Sin. CP 80200.
Tel: (667) 7139004 ext. 293.

DOI http://dx.doi.org/10.28960/revmeduas.2007-8013.v11.n1.009

Recibido 15 de Octubre 2020, aceptado 25 de Noviembre 2020


RESUMEN
Introducción: La enfermedad causada por el virus SARS-CoV-2, COVID-19, suele ser más benigna en niños que en los adultos. No se conoce su impacto en la morbimortalidad infantil en comparación a otros virus respiratorios estacionales como la influenza.
Objetivo: Comparar la carga en la morbimortalidad de COVID-19 con la de influenza en los niños. --- Métodos: Se seleccionaron estudios de cualquier diseño que compararan los desenlaces clínicos de COVID-19 con los de influenza en la población infantil. Los desenlaces analizados fueron mortalidad, duración de estancia hospitalaria, y necesidad de oxígeno, ventilación mecánica, o cuidados intensivos. La búsqueda se realizó en Medline, The Cochrane Library, Google Scholar, y Epistemonikos. La búsqueda y extracción de datos se realizaron por dos evaluadores independientes. --- Resultados: De 438 artículos encontrados se seleccionaron 4 estudios que cumplieron los criterios de inclusión. Los 4 fueron estudios retrospectivos, con entornos distintos, que comparaban niños con COVID-19 diagnosticados en el 2020 con niños con influenza de periodos o años previos. No se encontraron diferencias significativas en la mortalidad, días de estancia, ni requerimientos de oxígeno, ventilación mecánica o terapia intensiva. La calidad de la evidencia se consideró muy baja. --- Conclusiones: La morbimortalidad de los niños con COVID-19 puede ser similar a la de los niños con influenza, pero la certeza de la evidencia es muy baja.
Palabras clave: COVID-19; infecciones por coronavirus; influenza.

ABSTRACT
Introduction: The disease caused by the SARS-CoV-2 virus, COVID-19, is usually more benign in children than adults. Its impact in childhood morbimortality, in relation to other stational respiratory viruses such as influenza is not known. --- Objective: To compare the burden in morbimortality of COVID-19 with that of influenza in children. --- Methods: Studies of any design that compared the clinical outcomes of children with COVID-19 with those in children with influenza were selected. The outcomes included mortality, duration of hospital stay, and need for oxygen, mechanical ventilation, or intensive care. The search was performed in Medline, The Cochrane Library, Google Scholar, and Epistemonikos. Search and data extraction were done by two independent evaluators. --- Results: Of 438 articles found, 4 fulfilled the inclusion criteria. All 4 were retrospective studies, with different settings, that compared children with COVID-19 diagnosed during 2020 with children with influenza diagnosed in previous periods or years. No significant differences were found in mortality, days of stay, or oxygen, mechanical ventilation or intensive care need. The quality of evidence was considered very low. --- Conclusions: The morbimortality of children with COVID-19 may be similar to that of influenza, but the certainty of the evidence is very low.
Key words: COVID-19; coronavirus infections; influenza.


REFERENCIAS

  1. Johns Hopkins University of Medicine. COVID-19 dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) [Internet]. Johns Hopkins University of Medicine. [cited 2020 Oct 12]. Available from: https://coronavirus.jhu.edu/map.html.
  2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497–506. DOI: 10.1016/S0140-6736(20)30183-5
  3. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics. 2020 Mar 1. DOI: 10.1542/peds.2020-0702
  4. Tagarro A, Epalza C, Santos M, Sanz-Santaeufemia FJ, Otheo E, Moraleda C, et al. Screening and Severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain. JAMA Pediatr. 2020 Apr 8. DOI:10.1001/jamapediatrics.2020.1346
  5. Wu Q, Xing Y, Shi L, Li W, Gao Y, Pan S, et al. Coinfection and Other Clinical Characteristics of COVID-19 in Children. Pediatrics. 2020 May 6;146(1). DOI: 10.1542/peds.2020-0961
  6. Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020 Mar 5;55(5):1169–74. DOI: 10.1002/ppul.24718
  7. Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020 Jun 6;395(10239):1771–8.
  8. Licciardi F, Pruccoli G, Denina M, Parodi E, Taglietto M, Rosati S, et al. SARS-CoV-2-Induced Kawasaki-Like Hyperinflammatory Syndrome: A Novel COVID Phenotype in Children. Pediatrics. 2020 May 21;146(2). DOI:https://doi.org/10.1016/ S0140-6736(20)31103-X
  9. Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F, et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020 Jun 3. DOI: https://doi.org/10.1136/bmj.m2094
  10. McCrindle BW, Manlhiot C. SARS-CoV-2-Related Inflammatory Multisystem Syndrome in Children: Different or Shared Etiology and Pathophysiology as Kawasaki Disease? JAMA. 2020 Jun 8. DOI:10.1001/jama.2020.10370
  11. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med. 2020 Jul 23;383(4):334–46. DOI: 10.1056/NEJMoa2021680
  12. Song X, Delaney M, Shah RK, Campos JM, Wessel DL, DeBiasi RL. Comparison of Clinical Features of COVID-19 vs Seasonal Influenza A and B in US Children. JAMA Netw Open. 2020 Sep 1;3(9):e2020495. DOI:10.1001/jamanetworkopen.2020.20495
  13. Lafond KE, Nair H, Rasooly MH, Valente F, Booy R, Rahman M, et al. Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982-2012: A Systematic Analysis. PLoS Med. 2016 Mar 24;13(3):e1001977. DOI:https://doi.org/10.1371/journal.pmed.1001977
  14. Wang X, Li Y, O’Brien KL, Madhi SA, Widdowson M-A, Byass P, et al. Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study. Lancet Glob Health. 2020 Feb 20;8(4):e497–510. DOI: 10.1016/S2214-109X(19)30545-5
  15. Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011 Apr;64(4):401–6. DOI: 10.1016/j.jclinepi.2010.07.015
  16. Bhopal S, Bagaria J, Bhopal R. Children’s mortality from COVID-19 compared with all-deaths and other relevant causes of death: epidemiological information for decision-making by parents, teachers, clinicians and policymakers. Public Health. 2020 May 30;185:19–20. DOI: 10.1016/j.puhe.2020.05.047
  17. Gupta S, Malhotra N, Gupta N, Agrawal S, Ish P. The curious case of coronavirus disease 2019 (COVID-19) in children. J Pediatr. 2020 Jul;222:258–9. DOI: 10.1016/j.jpeds.2020.04.062
  18. Li Y, Wang H, Wang F, Du H, Liu X, Chen P, et al. Comparison of hospitalized patients with pneumonia caused by COVID-19 and influenza A in children under 5 years. Int J Infect Dis. 2020 Sep;98:80–3. DOI: 10.1016/j.ijid.2020.06.026
  19. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. DOI:https://doi.org/10.1371/journal.pmed.1000097.
  20. Cuadrado-Payán E, Montagud-Marrahi E, Torres-Elorza M, Bodro M, Blasco M, Poch E, et al. SARS-CoV-2 and influenza virus co-infection. Lancet. 2020 May 16;395(10236):e84. DOI:https://doi.org/10.1016/ S0140-6736(20)31052-7
  21. Lacobucci G. Covid-19: Risk of death more than doubled in people who also had flu, English data show. BMJ. 2020 Sep 23;370:m3720. DOI: 10.1136/bmj.m3720
  22. Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, et al. Decreased Influenza Activity During the COVID-19 Pandemic - United States, Australia, Chile, and South Africa, 2020. MMWR Morb Mortal Wkly Rep. 2020 Sep 18;69(37):1305–9. DOI: 10.15585/mmwr.mm6937a6