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Parri N, Magistà AM, Marchetti F, Cantoni B, Arrighini A, Romanengo M, Felici E, Urbino A, Da Dalt L, Verdoni L, Armocida B, Covi B, Mariani I, Giacchero R, Musolino AM, Binotti M, Biban P, Fasoli S, Pilotto C, Nicoloso F, Raggi M, Miorin E, Buonsenso D, Chiossi M, Agostiniani R, Plebani A, Barbieri MA, Lanari M, Arrigo S, Zoia E, Lenge M, Masi S, Barbi E, Lazzerini M. Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks. Eur J Pediatr 2020; 179:1315-1323. [PMID: 32495147 PMCID: PMC7269687 DOI: 10.1007/s00431-020-03683-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 02/07/2023]
Abstract
Detailed data on clinical presentations and outcomes of children with COVID-19 in Europe are still lacking. In this descriptive study, we report on 130 children with confirmed COVID-19 diagnosed by 28 centers (mostly hospitals), in 10 regions in Italy, during the first months of the pandemic. Among these, 67 (51.5%) had a relative with COVID-19 while 34 (26.2%) had comorbidities, with the most frequent being respiratory, cardiac, or neuromuscular chronic diseases. Overall, 98 (75.4%) had an asymptomatic or mild disease, 11 (8.5%) had moderate disease, 11 (8.5%) had a severe disease, and 9 (6.9%) had a critical presentation with infants below 6 months having significantly increased risk of critical disease severity (OR 5.6, 95% CI 1.3 to 29.1). Seventy-five (57.7%) children were hospitalized, 15 (11.5%) needed some respiratory support, and nine (6.9%) were treated in an intensive care unit. All recovered.Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs. What is Known: • There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases. What is New: • Among a case series of 130 children, mostly diagnosed at hospital level, and with a relatively high rate (26.2%) of comorbidities, about three-quarter had an asymptomatic or mild disease. • However, 57.7% were hospitalized, 11.5% needed some respiratory support, and 6.9% were treated in an intensive care unit.
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Affiliation(s)
- Niccolò Parri
- Department of Emergency Medicine and Trauma Center, Meyer University Children’s Hospital, Florence, Italy
| | | | | | - Barbara Cantoni
- Healthcare Professional Department Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alberto Arrighini
- Pediatric Emergency Department, Presidio Ospedale dei Bambini, ASST Spedali Civili, Brescia, Italy
| | | | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, The Children Hospital, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Antonio Urbino
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Liviana Da Dalt
- Department for Woman and Child Health-Pediatric Emergency Department, University of Padua, Padua, Italy
| | - Lucio Verdoni
- Department of Pediatrics, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Benedetta Armocida
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Benedetta Covi
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Ilaria Mariani
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Anna Maria Musolino
- Department of Pediatric Emergency Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Marco Binotti
- Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità University Hospital, Novara, Italy
| | - Paolo Biban
- Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona, Italy
| | | | - Chiara Pilotto
- Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy
| | | | | | | | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Anna Plebani
- Pediatric Emergency Unit, Filippo Del Ponte Hospital, ASST-Settelaghi, Varese, Italy
| | | | - Marcello Lanari
- Pediatric Emergency Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Serena Arrigo
- Department of Pediatrics, Hospital Filippo Del Ponte, Varese, Italy
| | - Elena Zoia
- Department of Pediatrics, Hospital V. Buzzi, Milan, Italy
| | - Matteo Lenge
- Clinical Trial Office, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Stefano Masi
- Department of Emergency Medicine and Trauma Center, Meyer University Children’s Hospital, Florence, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy
- Department of Medicine, Surgery and Health Science, Department of Pediatrics, University of Trieste, Trieste, Italy
| | - Marzia Lazzerini
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy
| | - on behalf of the CONFIDENCE and COVID-19 Italian Pediatric Study Networks
- Department of Emergency Medicine and Trauma Center, Meyer University Children’s Hospital, Florence, Italy
- Department of Pediatrics, Community Pediatrics, Ravenna, Italy
- Department of Pediatrics, Ravenna Hospital, Ravenna, Italy
- Healthcare Professional Department Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Pediatric Emergency Department, Presidio Ospedale dei Bambini, ASST Spedali Civili, Brescia, Italy
- IRCCS Istituto Gaslini, Genoa, Italy
- Pediatric and Pediatric Emergency Unit, The Children Hospital, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
- Department for Woman and Child Health-Pediatric Emergency Department, University of Padua, Padua, Italy
- Department of Pediatrics, Papa Giovanni XXIII Hospital, Bergamo, Italy
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy
- Department of Pediatrics, Lodi Hospital, Lodi, Italy
- Department of Pediatric Emergency Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità University Hospital, Novara, Italy
- Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona, Italy
- Paediatric Unit, Carlo Poma Hospital, Mantua, Italy
- Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy
- Family Pediatrician, Udine, Italy
- ICU, Pain Therapy Unit, Rovereto Hospital, Trento, Italy
- Department of Pediatrics, Latisana-Palmanova, ASUFC, Udine, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Pediatrics, ASL 4 Liguria, Lavagna, Italy
- Department of Pediatrics, Ospedale San Jacopo, Pistoia, Italy
- Pediatric Emergency Unit, Filippo Del Ponte Hospital, ASST-Settelaghi, Varese, Italy
- Pediatric Emergency Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy
- Department of Pediatrics, Hospital Filippo Del Ponte, Varese, Italy
- Department of Pediatrics, Hospital V. Buzzi, Milan, Italy
- Clinical Trial Office, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Department of Medicine, Surgery and Health Science, Department of Pediatrics, University of Trieste, Trieste, Italy
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