Table 5

Comparison of clinical symptoms, management and outcomes among reported paediatric COVID-19 cases in HICs (n=5641 cases, 60 studies) and LMICs (n=3694, 69 studies)

CharacteristicsHICsLMICsRR
LMICs vs HICs,
(95% CI)
Events/total patientsMean proportion % (95% CI)Events/total patientsMean proportion % (95% CI)
Clinical symptoms
 Fever2276/333272.0 (66.3 to 77.0) Embedded Image 1300/296450.0 (47.4 to 52.6) Embedded Image 0.64 (0.61 to 0.67)
 Cough995/273033.2 (27.5 to 39.5)812/253139.2 (36.2 to 42.3)0.88 (0.82 to 0.95)
 Comorbidity1069/335733.7 (27.4 to 38.5)521/272920.8 (18.3 to 23.4)0.60 (0.55 to 0.66)
 Rashes491/210924.9 (17.9 to 33.5)253/227820.2 (17.5 to 23.2)0.48 (0.41 to 0.55)
 Nausea/vomiting668/237430.3 (24.3 to 37.0)212/186915.3 (12.6 to 18.3)0.40 (0.35 to 0.46)
 Conjunctivitis309/273213.1 (8.4 to 20.1)220/226619.5 (16.9 to 22.5)0.86 (0.73 to 1.01)
 Dyspnoea543/245423.6 (18.5 to 29.6)336/287820.6 (18.1 to 23.4)0.53 (0.47 to 0.60)
 Kawasaki shock/sign583/208721.9 (14.1 to 32.5)238/227821.4 (18.5 to 24.6)0.37 (0.33 to 0.43)
 Fatigue394/194316.8 (12.2 to 22.6)315/253115.6 (13.3 to 18.3)0.61 (0.54 to 0.70)
 Abdominal pain457/226622.7 (16.4 to 30.5)169/186916.6 (12.9 to 21.1)0.45 (0.38 to 0.53)
 Nasal symptoms425/254917.8 (14.4 to 21.8)269/251915.4 (13.2 to 17.8)0.64 (0.56 to 0.74)
 Diarrhoea527/236527.5 (21.5 to 34.6)125/110514.7 (12.4 to 17.3)0.51 (0.42 to 0.61)
 Neurological symptoms493/319715.0 (11.6 to 19.0)200/227810.4 (8.8 to 12.3)0.57 (0.49 to 0.67)
 Asymptomatic263/24286.4 (4.2 to 9.7)851/365620.2 (18.4 to 22.1)2.15 (1.89 to 2.44)
 Pharyngeal erythema73/14946.7 (4.3 to 10.1)519/253140.7 (37.4 to 44.0)4.20 (3.31 to 5.32)
Clinical management
 Antibiotics908/187536.4 (25.6 to 48.7)437/173527.0 (22.9 to 31.5)0.52 (0.47 to 0.57)
 IVIG504/186731.6 (20.3 to 45.5)194/165514.7 (12.1 to 17.7)0.43 (0.37 to 0.51)
 Aspirin187/98516.0 (9.1 to 26.8)51/160310.4 (7.2 to 14.7)0.17 (0.12 to 0.23)
 Systemic steroids566/252327.2 (19.0 to 37.3)235/170618.0 (15.2 to 21.2)0.61 (0.53 to 0.71)
 Inotropes309/230919.1 (12.3 to 28.5)45/154711.9 (8.5 to 16.5)0.22 (0.16 to 0.30)
 Antimalarial241/169613.6 (8.7 to 20.8)95/160313.5 (10.5 to 17.3)0.42 (0.33 to 0.52)
 Mechanical ventilation387/293017.2 (13.1 to 22.3)103/247610.8 (8.6 to 13.4)0.32 (0.26 to 0.39)
 Antiviral230/237211.4 (7.7 to 16.6)297/164725.2 (21.1 to 29.9)1.86 (1.58 to 2.18)
 Interferon0/995138/160330.5 (24.1 to 37.7)
 Traditional medicine0/252322/170611.3 (8.0 to 15.7)
Clinical outcomes
 Recovered5269/564191.0 (87.7 to 93.4)3435/369483.9 (81.2 to 86.2)0.99 (0.98 to 1.01)
 ICU admission993/564126.0 (24.0 to 28.0)366/36949.9 (8.5 to 11.6)0.56 (0.50 to 0.63)
 Deaths40/47102.9 (2.1 to 4.1)56/21925.2 (4.1 to 6.7)2.14 (1.43 to 3.20)
  • HICs, high-income countries; ICU, intensive care unit; IVIG, intravenous immunoglobulin; LMICs, low-income and middle-income countries; RR, relative risk.