From asymptomatic to critical illness - different clinical manifestations of COVID-19 in children

The global pandemic infectious disease that was named the new coronavirus disease (COVID 19), spread throughout the world, causing a major public health emergency. The causative virus of COVID-19, called SARS CoV-2, can infect all age groups. Various clinical signs and symptoms have been observed in neonates, children, and adolescents during the COVID-19 outbreak. The clinical manifestations of COVID-19 might be different due to the medical conditions and comorbid status in elderly and pediatric patients. The rise in cases among children has been reported during the COVID-19 pandemic. Although infected children generally appear to be asymptomatic or have only mild symptoms, COVID-19 in children may also involve a wide spectrum of clinical manifestations ranging from asymptomatic carriers to life-threatening and fatal diseases, as COVID-19 is a systemic disease that can affect multiple organs. Due to the lack of knowledge in the current literature, it is necessary to describe the atypical clinical features, including extrapulmonary manifestations, in pediatric patients with COVID-19. This review is conducted to identify knowledge gaps regarding the broad spectrum of clinical signs and symptoms of children with COVID-19.