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

被引：56

作者：

Garazzino, Silvia ^{[1
]}

Lo Vecchio, Andrea ^{[2
]}

Pierantoni, Luca ^{[3
]}

Calo Carducci, Francesca Ippolita ^{[4
]}

Marchetti, Federico ^{[5
]}

Meini, Antonella ^{[6
]}

Castagnola, Elio ^{[7
]}

Vergine, Gianluca ^{[8
]}

Dona, Daniele ^{[9
]}

Bosis, Samantha ^{[10
]}

Dodi, Icilio ^{[11
]}

Venturini, Elisabetta ^{[12
]}

Felici, Enrico ^{[13
]}

Giacchero, Roberta ^{[14
]}

Denina, Marco ^{[1
]}

Pierri, Luca ^{[2
]}

Nicolini, Giangiacomo ^{[15
]}

Montagnani, Carlotta ^{[12
]}

Krzysztofiak, Andrzej ^{[4
]}

Bianchini, Sonia ^{[16
]}

Marabotto, Caterina ^{[4
]}

Tovo, Pier-Angelo ^{[1
]}

Pruccoli, Giulia ^{[1
]}

Lanari, Marcello ^{[3
]}

Villani, Alberto ^{[4
]}

Castelli Gattinara, Guido ^{[4
]}

机构：

[1] Univ Turin, Regina Margherita Childrens Hosp, Pediat Infect Dis Unit, Turin, Italy

[2] Univ Naples Federico II, Sect Pediat, Dept Translat Med Sci, Naples, Italy

[3] IRCCS Azienda Osped Univ Bologna, Pediat Emergency Unit, Bologna, Italy

[4] Osped Bambino Gesu IRCCS, Univ Hosp Dept, Rome, Italy

[5] Santa Maria delle Croci Hosp, Dept Pediat, Ravenna, Italy

[6] Univ Brescia, Dept Expt & Clin Sci, Pediat Clin, Brescia, Italy

[7] IRCCS Ist Giannina Gaslini, Infect Dis Unit, Genoa, Italy

[8] Osped Infermi Rimini, UOC Pediat, Rimini, Italy

[9] Univ Hosp Padua, Div Pediat Infect Dis, Dept Womens & Childrens Hlth, Padua, Italy

[10] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Milan, Italy

[11] Pietro Barilla Childrens Hosp, Emergency & Gen Pediat Unit, Parma, Italy

[12] Meyer Childrens Univ Hosp, Infect Dis Unit, Florence, Italy

[13] Children Hosp, Pediat & Pediat Emergency Unit, AO SS Antonio & Biagio & C Arrigo, Alessandria, Italy

[14] UOC Pediat ASST Lodi, Lodi, Italy

[15] San Martino Hosp, UOC Pediat, Belluno, Italy

[16] ASST Santi Paolo & Carlo Hosp, Dept Pediat, Milan, Italy

来源：

FRONTIERS IN PEDIATRICS | 2021年 / 9卷

关键词：

SARS-CoV-2; infection; children; multisystem inflammatory syndrome; MIS-C; COVID-19; COVID-19; CHILDREN;

D O I：

10.3389/fped.2021.649358

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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.

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