Epidemiology, Clinical Features and Prognostic Factors of Pediatric SARS-CoV-2 Infection: Results From an Italian Multicenter Study

Garazzino, S.; Vecchio, A. L.; Pierantoni, L.; Carducci, F. I. C.; Marchetti, F.; Meini, A.; Castagnola, E.; Vergine, G.; Dona, D.; Bosis, S.; Dodi, I.; Venturini, E.; Felici, E.; Giacchero, R.; Denina, M.; Pierri, L.; Nicolini, G.; Montagnani, C.; Krzysztofiak, A.; Bianchini, S.; Marabotto, C.; Tovo, P. -A.; Pruccoli, G.; Lanari, M.; Villani, A.; Gattinara, G. C.; Valeria, C.; Maria, S. F.; Giovanni, C.; Paolo, B.; Paola, B.; Carlo, A.; Chiara, G.; Vera, Q.; Sara, R.; Ivana, R.; Carmelina, C.; Luisa, A.; Luciana, P.; Giuseppe, B.; Ilaria, P.; Simonetta, C.; Paola, L.; Andrea, G.; Rino, A.; Salvatore, C.; Ahmad, K.; Luca, B.; Nadia, R.; Cristina, D.; Laura, P.; Paolo, M.; Alessandro, V.; Ludovica, F.; Pasquale, C.; Gianna, B.; Paola, V.; Gianluca, T.; Paola, G.; Luca, B.; Angelina, V.; Giorgio, Z.; Luigi, M.; Paola, G.; Di Filippo, P.; Chiara, C.; Alessandra, I.; Alessandro, P.; Marta, F.; Sara, R.; Sara, R.; Paola, M.; Alessandro, F.; Costantino, G.; Giuliana, F.; Graziano, B.; Pajno, R.; Stefano, M.; Alessia, R.; Rosa, F.; Paola, S. V.; Marco, P.; Piero, V.; Raffaele, P.; Maria, M. A.; Raffaele, B.; Carolina, S.; Cristina, G. M.; Paola, C.; Maria, P.; Susanna, E.; Giovanni, P.; Valentina, S. M.; Valentina, M.; Laura, C.; Francesco, N.; Federica, M.; Bondone, C.; Giacomo, S.; Agostina, M.; Lorenzo, F.; Caterina, S.; Rita, G. M.; Cristina, F.; Luisa, G.

doi:10.3389/fped.2021.649358

Background: Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear and optimal treatment is debated. The objective of our study was to investigate epidemiological, clinical and therapeutic characteristics of pediatric SARS-CoV-2 infection, focusing on risk factors for complicated and critical disease. Methods: The present multicenter Italian study was promoted by the Italian Society of Pediatric Infectious Diseases, involving both pediatric hospitals and general pediatricians/family doctors. All subjects under 18 years of age with documented SARS-CoV-2 infection and referred to the coordinating center were enrolled from March 2020. Results: As of 15 September 2020, 759 children were enrolled (median age 7.2 years, IQR 1.4; 12.4). Among the 688 symptomatic children, fever was the most common symptom (81.9%). Barely 47% of children were hospitalized for COVID-19. Age was inversely related to hospital admission (p < 0.01) and linearly to length of stay (p = 0.014). One hundred forty-nine children (19.6%) developed complications. Comorbidities were risk factors for complications (p < 0.001). Viral coinfections, underlying clinical conditions, age 5–9 years and lymphopenia were statistically related to ICU admission (p < 0.05). Conclusions: Complications of COVID-19 in children are related to comorbidities and increase with age. Viral co-infections are additional risk factors for disease progression and multisystem inflammatory syndrome temporarily related to COVID-19 (MIS-C) for ICU admission.

Epidemiology, Clinical Features and Prognostic Factors of Pediatric SARS-CoV-2 Infection: Results From an Italian Multicenter Study / Garazzino S.; Vecchio A.L.; Pierantoni L.; Carducci F.I.C.; Marchetti F.; Meini A.; Castagnola E.; Vergine G.; Dona D.; Bosis S.; Dodi I.; Venturini E.; Felici E.; Giacchero R.; Denina M.; Pierri L.; Nicolini G.; Montagnani C.; Krzysztofiak A.; Bianchini S.; Marabotto C.; Tovo P.-A.; Pruccoli G.; Lanari M.; Villani A.; Gattinara G.C.; Valeria C.; Maria S.F.; Giovanni C.; Paolo B.; Paola B.; Carlo A.; Chiara G.; Vera Q.; Sara R.; Ivana R.; Carmelina C.; Luisa A.; Luciana P.; Giuseppe B.; Ilaria P.; Simonetta C.; Paola L.; Andrea G.; Rino A.; Salvatore C.; Ahmad K.; Luca B.; Nadia R.; Cristina D.; Laura P.; Paolo M.; Alessandro V.; Ludovica F.; Pasquale C.; Gianna B.; Paola V.; Gianluca T.; Paola G.; Luca B.; Angelina V.; Giorgio Z.; Luigi M.; Paola G.; Di Filippo P.; Chiara C.; Alessandra I.; Alessandro P.; Marta F.; Sara R.; Sara R.; Paola M.; Alessandro F.; Costantino G.; Giuliana F.; Graziano B.; Pajno R.; Stefano M.; Alessia R.; Rosa F.; Paola S.V.; Marco P.; Piero V.; Raffaele P.; Maria M.A.; Raffaele B.; Carolina S.; Cristina G.M.; Paola C.; Maria P.; Susanna E.; Giovanni P.; Valentina S.M.; Valentina M.; Laura C.; Francesco N.; Federica M.; Bondone C.; Giacomo S.; Agostina M.; Lorenzo F.; Caterina S.; Rita G.M.; Cristina F.; Luisa G.. - In: FRONTIERS IN PEDIATRICS. - ISSN 2296-2360. - ELETTRONICO. - 9:(2021), pp. 649358.1-649358.10. [10.3389/fped.2021.649358]