tetano
Editor, Senior Moderator
- Marzia Lazzerini[SUP]1[/SUP] , Idanna Sforzi[SUP]2[/SUP] , Sandra Trapani[SUP]3[/SUP] , Paolo Biban[SUP]4[/SUP] , Davide Silvagni[SUP]4[/SUP] , Giovanna Villa[SUP]5[/SUP] , Jessica Tibaldi[SUP]5[/SUP] , Luca Bertacca[SUP]6[/SUP] , Enrico Felici[SUP]7[/SUP] , Giuseppina Perricone[SUP]7[/SUP] , Roberta Parrino[SUP]8[/SUP] , Claudia Gio?[SUP]9[/SUP] , Sara Lega[SUP]1[/SUP] , Mariasole Conte[SUP]1[/SUP] , Federico Marchetti[SUP]10[/SUP] , Annamaria Magista[SUP]11[/SUP] , Paola Berlese[SUP]12[/SUP] , Stefano Martelossi[SUP]12[/SUP] , Francesca Vaienti[SUP]13[/SUP] , Enrico Valletta[SUP]13[/SUP] , Margherita Mauro[SUP]14[/SUP] , Roberto Dall?Amico[SUP]14[/SUP] , Silvia Fasoli[SUP]15[/SUP] , Antonio Gatto[SUP]16[/SUP] , Antonio Chiaretti[SUP]16[/SUP] , Danica Dragovic[SUP]17[/SUP] , Paola Pascolo[SUP]17[/SUP] , Chiara Pilotto[SUP]18[/SUP] , Ilaria Liguoro[SUP]18[/SUP] , Elisabetta Miorin[SUP]19[/SUP] , Francesca Saretta[SUP]19[/SUP] , Gian Luca Trobia[SUP]20[/SUP] , Antonella Di Stefano[SUP]20[/SUP] , Azzurra Orlandi[SUP]21[/SUP] , Fabio Cardinale[SUP]21[/SUP] , Riccardo Lubrano[SUP]22[/SUP] , Alessia Testa[SUP]22[/SUP] , Marco Binotti[SUP]23[/SUP] , Valentina Moressa[SUP]1[/SUP] , Egidio Barbi[SUP]1,24[/SUP] , Benedetta Armocida[SUP]1[/SUP]
, Ilaria Mariani[SUP]1[/SUP] , on behalf of COVID-19 Italian Pediatric Study Network[SUP]25[/SUP]
Very few studies describe factors associated with COVID-19 diagnosis in children.
Aim
We here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.
Methods
We included cases aged 0?18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.
Results
Among 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52?90.55; p?<?0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19?5.02; p?<?0.0001), fever (AOR: 3.05%; 95% CI: 1.67?5.58; p?=?0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69?9.84; p?=?0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.
Conclusion
Recommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.
full article
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.14.2001248#html_fulltext