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

• Main Authors: 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
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-03-01
• Series: Frontiers in Pediatrics
• Subjects: SARS-CoV-2 infection; children; multisystem inflammatory syndrome; MIS-C; COVID-19
• Online Access: https://www.frontiersin.org/articles/10.3389/fped.2021.649358/full

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.