Abstract: Objective To summarize the epidemiological, clinical characteristics and discharge outcomes of children with COVID-19 and to provide evidence to guide the prevention and treatment of COVID-19. MethodsConfirmed COVID-19 cases of children aged from 1 month to 18 years were included. We excluded articles on SARS-CoV-2 nucleic acid detection reagents and molecular diagnosis and those from which children's data could not be extracted. Literature was searched in the database of PubMed, CBM and CNKI from January 1st, 2019 to March 11th, 2020 and a supplementary search was performed in the WHO COVID-19 literature database and references of the included literature. Risk of bias assessment was conducted by the associate chief physician of Department of Infectious Disease in Children's Hospital of Fudan University. Literature evaluation and data extraction were instructed and reviewed by professionals from Center for Clinical Guideline Development and Evaluation in Children's Hospital of Fudan University. ResultsA total of 18 literature was included according to the eligibility criteria with 13 in Chinese and 5 in English. Among them, there are 10 case reports and 8 case series reports, 3 of which had acceptable risk of bias. One hundred and twenty-seven children with COVID-19 were identified including 47 of mild type, 78 of common type and 2 of critical type. They were at the age of 1 day to 17 years with 66 males (52%) and were all tested positive for SARS-CoV-2 nucleic acid. The number of cases with history of residence or travel in Hubei Province or contact with people from Hubei Province, and cases of family clustering accounted for 58%（74/127）and 75%（79/105）respectively. Of 11 literature mentioning the time for diagnosis, 9 described it as 1-3 days. Seventy-two cases had fever and specific body temperature values with 43 cases at 37.3-39℃, and 6 cases at >39 ℃. Of 10 literature mentioning fever duration, 7 described it as 1 day. Coughing, nasal congestion/runny nose/sneezing, diarrhea and vomiting, and asymptomatic children were respectively identified in 11 literature (47 cases), 6 literature (14 cases), 4 literature (10 cases with 1 critical illness and 4 of first symptoms) and in 7 literature (26 cases with 15 of pneumonia by imaging) . A total of 16 literature (105 cases) reported routine blood test results with WBC 3.2-16.71 (×109·L-1) and 2 of decrease in absolute lymphocytes. Imaging examinations were performed in 126 cases from 17 literature. Four of 11 cases of chest X-ray showed inflammatory exudation at one side and there were 80 cases (70%) with signs of pneumonia and 35 cases (30%) without that in 115 cases undergoing chest CT. Among the 80 children with CT signs of pneumonia, there were 57 for ground-glass shadows (71%), 42 for small nodules/consolidation shadows (52%) (coexisting with ground-glass shadows), 4 for grid shadows and 3 for bronchopneumonia-like changes. Seventy-three cases (57%) received antiviral therapy including interferons, peramivir/oseltamivir, ribavirin, Kaltera (lopinavir/ritonavir), arbidol, darunavir/cobicistat, etc. ; 11 cases were treated with Chinese patent medicine and 3 cases did not receive any treatment. Forty-six children were discharged or tested negative for SRAS-CoV-2 by nasopharyngeal swabs after 5 to 22 days. The longest disease duration was 30 days that nucleic acid test by stools still remained positive at the 30th day of observation. ConclusionChildren with COVID-19 were more common in family clusters. They were featured by mild and common types with short fever duration, mild respiratory symptoms, short intervals between the onset of symptoms and diagnosis and a good prognosis.