Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

Niccolò Parri¹, Anna Maria Magistà², Federico Marchetti³, Barbara Cantoni⁴, Alberto Arrighini⁵, Marta Romanengo⁶, Enrico Felici⁷, Antonio Urbino⁸, Liviana Da Dalt⁹, Lucio Verdoni¹⁰, Benedetta Armocida¹¹, Benedetta Covi¹¹, Ilaria Mariani¹¹, Roberta Giacchero¹², Anna Maria Musolino¹³, Marco Binotti¹⁴, Paolo Biban¹⁵, Silvia Fasoli¹⁶, Chiara Pilotto¹⁷, Flavia Nicoloso¹⁸, Massimiliano Raggi¹⁹, Elisabetta Miorin²⁰, Danilo Buonsenso^{21

22}, Massimo Chiossi²³, Rino Agostiniani²⁴, Anna Plebani²⁵, Maria Antonietta Barbieri¹³, Marcello Lanari²⁶, Serena Arrigo²⁷, Elena Zoia²⁸, Matteo Lenge^{29

30

31}, Stefano Masi¹, Egidio Barbi^{11

32}, Marzia Lazzerini³³; CONFIDENCE and COVID-19 Italian Pediatric Study Networks

Affiliations

¹ Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.
² Department of Pediatrics, Community Pediatrics, Ravenna, Italy.
³ Department of Pediatrics, Ravenna Hospital, Ravenna, Italy.
⁴ Healthcare Professional Department Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
⁵ Pediatric Emergency Department, Presidio Ospedale dei Bambini, ASST Spedali Civili, Brescia, Italy.
⁶ IRCCS Istituto Gaslini, Genoa, Italy.
⁷ Pediatric and Pediatric Emergency Unit, The Children Hospital, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
⁸ Department of Pediatric Emergency, Regina Margherita Children's Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
⁹ Department for Woman and Child Health-Pediatric Emergency Department, University of Padua, Padua, Italy.
¹⁰ Department of Pediatrics, Papa Giovanni XXIII Hospital, Bergamo, Italy.
¹¹ Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
¹² Department of Pediatrics, Lodi Hospital, Lodi, Italy.
¹³ Department of Pediatric Emergency Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
¹⁴ Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità University Hospital, Novara, Italy.
¹⁵ Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona, Italy.
¹⁶ Paediatric Unit, Carlo Poma Hospital, Mantua, Italy.
¹⁷ Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy.
¹⁸ Family Pediatrician, Udine, Italy.
¹⁹ ICU, Pain Therapy Unit, Rovereto Hospital, Trento, Italy.
²⁰ Department of Pediatrics, Latisana-Palmanova, ASUFC, Udine, Italy.
²¹ Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
²² Università Cattolica del Sacro Cuore, Rome, Italy.
²³ Department of Pediatrics, ASL 4 Liguria, Lavagna, Italy.
²⁴ Department of Pediatrics, Ospedale San Jacopo, Pistoia, Italy.
²⁵ Pediatric Emergency Unit, Filippo Del Ponte Hospital, ASST-Settelaghi, Varese, Italy.
²⁶ Pediatric Emergency Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
²⁷ Department of Pediatrics, Hospital Filippo Del Ponte, Varese, Italy.
²⁸ Department of Pediatrics, Hospital V. Buzzi, Milan, Italy.
²⁹ Clinical Trial Office, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
³⁰ Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
³¹ Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
³² Department of Medicine, Surgery and Health Science, Department of Pediatrics, University of Trieste, Trieste, Italy.
³³ Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy. marzia.lazzerini@burlo.trieste.it.

PMID: 32495147
PMCID: PMC7269687
DOI: 10.1007/s00431-020-03683-8

Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

Niccolò Parri et al. Eur J Pediatr. 2020 Aug.

. 2020 Aug;179(8):1315-1323.

doi: 10.1007/s00431-020-03683-8. Epub 2020 Jun 3.

Authors

Affiliations

¹ Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.
² Department of Pediatrics, Community Pediatrics, Ravenna, Italy.
³ Department of Pediatrics, Ravenna Hospital, Ravenna, Italy.
⁴ Healthcare Professional Department Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
⁵ Pediatric Emergency Department, Presidio Ospedale dei Bambini, ASST Spedali Civili, Brescia, Italy.
⁶ IRCCS Istituto Gaslini, Genoa, Italy.
⁷ Pediatric and Pediatric Emergency Unit, The Children Hospital, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
⁸ Department of Pediatric Emergency, Regina Margherita Children's Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
⁹ Department for Woman and Child Health-Pediatric Emergency Department, University of Padua, Padua, Italy.
¹⁰ Department of Pediatrics, Papa Giovanni XXIII Hospital, Bergamo, Italy.
¹¹ Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
¹² Department of Pediatrics, Lodi Hospital, Lodi, Italy.
¹³ Department of Pediatric Emergency Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
¹⁴ Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità University Hospital, Novara, Italy.
¹⁵ Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona, Italy.
¹⁶ Paediatric Unit, Carlo Poma Hospital, Mantua, Italy.
¹⁷ Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy.
¹⁸ Family Pediatrician, Udine, Italy.
¹⁹ ICU, Pain Therapy Unit, Rovereto Hospital, Trento, Italy.
²⁰ Department of Pediatrics, Latisana-Palmanova, ASUFC, Udine, Italy.
²¹ Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
²² Università Cattolica del Sacro Cuore, Rome, Italy.
²³ Department of Pediatrics, ASL 4 Liguria, Lavagna, Italy.
²⁴ Department of Pediatrics, Ospedale San Jacopo, Pistoia, Italy.
²⁵ Pediatric Emergency Unit, Filippo Del Ponte Hospital, ASST-Settelaghi, Varese, Italy.
²⁶ Pediatric Emergency Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
²⁷ Department of Pediatrics, Hospital Filippo Del Ponte, Varese, Italy.
²⁸ Department of Pediatrics, Hospital V. Buzzi, Milan, Italy.
²⁹ Clinical Trial Office, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
³⁰ Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
³¹ Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
³² Department of Medicine, Surgery and Health Science, Department of Pediatrics, University of Trieste, Trieste, Italy.
³³ Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy. marzia.lazzerini@burlo.trieste.it.

PMID: 32495147
PMCID: PMC7269687
DOI: 10.1007/s00431-020-03683-8

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.

Keywords: Adolescents; COVID-19; Children; Italy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

**Fig. 1**
Distributions of enrolled COVID-19 cases across regions in Italy

See this image and copyright information in PMC

Comment in

Reading the Compass - Procedural Sedation and COVID-19.
Thikkurissy S. Thikkurissy S. Pediatr Dent. 2021 Mar 15;43(2):78-79. Pediatr Dent. 2021. PMID: 33892827 No abstract available.

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Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

Affiliations

Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Comment in

References

MeSH terms

LinkOut - more resources

Full Text Sources