Frontiers in Pediatrics (Mar 2021)

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

  • Silvia Garazzino,
  • Andrea Lo Vecchio,
  • Luca Pierantoni,
  • Francesca Ippolita Calò Carducci,
  • Federico Marchetti,
  • Antonella Meini,
  • Elio Castagnola,
  • Gianluca Vergine,
  • Daniele Donà,
  • Samantha Bosis,
  • Icilio Dodi,
  • Elisabetta Venturini,
  • Enrico Felici,
  • Roberta Giacchero,
  • Marco Denina,
  • Luca Pierri,
  • Giangiacomo Nicolini,
  • Carlotta Montagnani,
  • Andrzej Krzysztofiak,
  • Sonia Bianchini,
  • Caterina Marabotto,
  • Pier-Angelo Tovo,
  • Giulia Pruccoli,
  • Marcello Lanari,
  • Alberto Villani,
  • Guido Castelli Gattinara,
  • The Italian SITIP-SIP Pediatric Infection Study Group,
  • Valeria Caldarelli,
  • Filippo Maria Salvini,
  • Giovanni Corsello,
  • Barba Paolo Del,
  • Paola Berlese,
  • Carlo Agostoni,
  • Chiara Ghizzi,
  • Vera Quadri,
  • Sara Riscassi,
  • Ivana Rabbone,
  • Carmelina Calitri,
  • Luisa Abbagnato,
  • Luciana Parola,
  • Giuseppe Banderali,
  • Ilaria Pacati,
  • Simonetta Cherubini,
  • Paola Lippi,
  • Andrea Guala,
  • Rino Agostiniani,
  • Salvatore Cazzato,
  • Ahmad Kantar,
  • Luca Baroero,
  • Nadia Rossi,
  • Cristina Dalmazzo,
  • Laura Panigati,
  • Paolo Manzoni,
  • Alessandro Vigo,
  • Ludovica Fiore,
  • Pasquale Comberiati,
  • Gianna Battezzati,
  • Paola Verna,
  • Gianluca Tornese,
  • Paola Gianino,
  • Luca Bertacca,
  • Angelina Vaccaro,
  • Giorgio Zavarise,
  • Luigi Marchione,
  • Paola Gallia,
  • Paola Di Filippo,
  • Chiara Centenari,
  • Alessandra Iacono,
  • Alessandro Plebani,
  • Marta Ferretti,
  • Sara Rizzi,
  • Sara Rossin,
  • Paola Marchisio,
  • Alessandro De Fanti,
  • Costantino De Giacomo,
  • Giuliana Ferrante,
  • Graziano Barera,
  • Pajno Roberta,
  • Stefano Martelossi,
  • Alessia Rocchi,
  • Rosa Francavilla,
  • Valin Paola Sogno,
  • Marco Poeta,
  • Piero Valentini,
  • Raffaele Papa,
  • Anna Maria Magistà,
  • Raffaele Badolato,
  • Carolina Saffioti,
  • Maria Cristina Greco,
  • Paola Costenaro,
  • Maria Di Pietro,
  • Susanna Esposito,
  • Giovanni Pieri,
  • Maria Valentina Spartà,
  • Valentina Maffini,
  • Laura Cursi,
  • Francesco Nunziata,
  • Federica Mignone,
  • Claudia Bondone,
  • Giacomo Stera,
  • Agostina Marolda,
  • Lorenzo Fiorica,
  • Caterina Sabatini,
  • Maria Rita Genovese,
  • Cristina Ferrari,
  • Luisa Galli

DOI
https://doi.org/10.3389/fped.2021.649358
Journal volume & issue
Vol. 9

Abstract

Read online

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.

Keywords