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The ongoing coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people, including infants and children. We carried out a comprehensive literature review to identify the underlying mechanisms and risk factors for severe COVID-19 in children, in comparison with the other two coronavirus outbreaks in the past, SARS and MERS. Search in the Pubmed and Scopus databases to identify publications between February 26, 2020 and June 10, 2020 identified 23 relevant papers in English. Children have so far accounted for 1.7-2% of the diagnosed cases of COVID-19. They often have milder disease than adults, and child deaths have been rare. The documented risk factors for severe disease in children are young age and underlying comorbidities, although the potentially fatal multisystem inflammatory syndrome (MIS) occurs in older children. It is unclear whether male gender and certain laboratory and imaging findings can also be considered as risk factors, due to current insufficiency of evidence. Reports on other potential factors, such as vitamin D level, responsiveness of the immune system, co-infections and genetic polymorphisms have not yet been published.
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10.1016/j.pcl.2020.07.014
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document_parses/pdf_json/d0b6c6687c17c0f8b76c04d18b527aef0ed0b042.json
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document_parses/pmc_json/PMC7392074.xml.json
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SPECIAL ARTICLE: Risk factors for severity in children with coronavirus-19 disease (COVID-19): A comprehensive literature review
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