Frontiers in Pediatrics (Aug 2023)

Clinical features of COVID-19 in Italian outpatient children and adolescents during Parental, Delta, and Omicron waves: a prospective, observational, cohort study

  • Costanza Di Chiara,
  • Costanza Di Chiara,
  • Riccardo Boracchini,
  • Giulia Sturniolo,
  • Alessia Barbieri,
  • Paola Costenaro,
  • Sandra Cozzani,
  • Marica De Pieri,
  • Cecilia Liberati,
  • Annachiara Zin,
  • Andrea Padoan,
  • Francesco Bonfante,
  • Fatima Kakkar,
  • Anna Cantarutti,
  • Daniele Donà,
  • Daniele Donà,
  • Carlo Giaquinto,
  • Carlo Giaquinto

DOI
https://doi.org/10.3389/fped.2023.1193857
Journal volume & issue
Vol. 11

Abstract

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IntroductionCOVID-19 features changed with the Omicron variant of SARS-CoV-2 in adults. This study aims to describe COVID-19 symptoms in children and adolescents during the Parental, Delta, and Omicron erasMethodsA single-centre, prospective observational study was conducted on individuals aged 0–20 years attending the University Hospital of Padua (Italy) from April 2020 to December 2022. COVID-19 cases were defined by positive SARS-CoV-2 molecular detection and/or serology; patient/family symptoms and virological positivity were considered to determine the infection onset. Variables were summarized and compared using appropriate tests of descriptive statisticsResultsA total of 509 cases [46% female, median age eight years (IQR: 4–12)] were studied. Three-hundred-eighty-seven (76%), 52 (10%), and 70 (14%) subjects experienced COVID-19 during the Parental, Delta, and Omicron waves, respectively. All subjects developed an asymptomatic/mild COVID-19. Overall, the most frequent symptoms were fever (47%) and rhinitis (21%), which showed a significant increasing incidence from the Parental to Omicron waves (p < 0.001). Conversely, diarrhea was most common during the pre-Omicron eras (p = 0.03). Stratifying symptoms according to the age group, fever, rhinitis, and skin rashes were observed more frequently among infants/toddlers; conversely, fatigue was more common in children older than five years. The duration of symptoms was similar across different SARS-CoV-2 variants of concern (VOCs); conversely, the number of symptoms varied according to the age group (p < 0.0001)DiscussionThis study showed differences in COVID-19 clinical presentation among infants, children, and adolescents and confirmed Omicron infection is more likely to be associated with upper respiratory symptoms. However, further population-based studies are needed to support these findings. In addition, active surveillance will play a crucial role in assessing the disease severity of future VOCs.

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