Dear Editor,
We read with great interest the systematic review by Liguoro and colleagues (Volume 179, issue 7) [1]. The authors aimed to systematically review the main clinical characteristics and outcomes of SARS-CoV-2 infections in the pediatric age. We want to congratulate the authors for establishing a timely and informative systematic review of COVID-19 in children. Certainly, the findings of Liguoro et al. hold significance for pediatricians. However, we would like to draw their attention to the following issues.
First, we observed that the expression of “children with suspected or confirmed SARS-CoV-2 infection” has been mentioned several times. But the authors did not provide important information about “children with confirmed SARS-CoV-2 infection.” Did children with confirmed SARS-CoV-2 infection involve laboratory-confirmed and/or clinically diagnosed COVID-19? We hope that the authors can clarify the diagnostic methods and adopt a uniform case definition throughout the manuscript.
Furthermore, some children may have been included in multiple publications, as admission dates overlap for reports from the same hospital. The case series from reference 31 Sun et al. [2] should be considered a duplicate considering a large retrospective study of 171 COVID-19-positive pediatric patients in ref. 10 Lu et al. [3] reported by the same hospital with the periods of recruitment overlapped. Including duplicates may introduce bias into a systematic review and may affect understanding of the disease and its epidemiology [4]. Thus, we suggest the authors should exclude isolated case reports and repeat case series from the same region or hospital to avoid duplicate data from large retrospective studies.
References
Liguoro I, Pilotto C, Bonanni M, Ferrari ME, Pusiol A, Nocerino A, Vidal E, Cogo P (2020) SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr 179(7):1029–1046. https://doi.org/10.1007/s00431-020-03684-7
Sun D, Li H, Lu XX, Xiao H, Ren J, Zhang FR, Liu ZS (2020) Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr 16(3):251–259. https://doi.org/10.1007/s12519-020-00354-4
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S, Li Y, Wu C, Liu H, Liu D, Shao J, Peng X, Yang Y, Liu Z, Xiang Y, Zhang F, Silva RM, Pinkerton KE, Shen K, Xiao H, Xu S, Wong GWK (2020) SARS-CoV-2 infection in children. N Engl J Med 382(17):1663–1665. https://doi.org/10.1056/NEJMc2005073
Bauchner H, Golub RM, Zylke J (2020) Editorial concern-possible reporting of the same patients with COVID-19 in different reports. JAMA 323(13):1256. https://doi.org/10.1001/jama.2020.3980
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MW conceived the design of the comments and made critical revision. JC and YL drafted the manuscript. All the authors approved the final version for publication.
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Cai, J., Lin, Y. & Wu, Mj. More on SARS-COV-2 infection in children and newborns. Eur J Pediatr 181, 1297 (2022). https://doi.org/10.1007/s00431-021-04225-6
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DOI: https://doi.org/10.1007/s00431-021-04225-6