Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

Eur J Pediatr. 2020 Aug;179(8):1315-1323. doi: 10.1007/s00431-020-03683-8. Epub 2020 Jun 3.

Abstract

Detailed data on clinical presentations and outcomes of children with COVID-19 in Europe are still lacking. In this descriptive study, we report on 130 children with confirmed COVID-19 diagnosed by 28 centers (mostly hospitals), in 10 regions in Italy, during the first months of the pandemic. Among these, 67 (51.5%) had a relative with COVID-19 while 34 (26.2%) had comorbidities, with the most frequent being respiratory, cardiac, or neuromuscular chronic diseases. Overall, 98 (75.4%) had an asymptomatic or mild disease, 11 (8.5%) had moderate disease, 11 (8.5%) had a severe disease, and 9 (6.9%) had a critical presentation with infants below 6 months having significantly increased risk of critical disease severity (OR 5.6, 95% CI 1.3 to 29.1). Seventy-five (57.7%) children were hospitalized, 15 (11.5%) needed some respiratory support, and nine (6.9%) were treated in an intensive care unit. All recovered.Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs. What is Known: • There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases. What is New: • Among a case series of 130 children, mostly diagnosed at hospital level, and with a relatively high rate (26.2%) of comorbidities, about three-quarter had an asymptomatic or mild disease. • However, 57.7% were hospitalized, 11.5% needed some respiratory support, and 6.9% were treated in an intensive care unit.

Keywords: Adolescents; COVID-19; Children; Italy.

MeSH terms

  • Adolescent
  • Betacoronavirus* / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • Child
  • Child, Preschool
  • Clinical Laboratory Techniques / methods
  • Clinical Laboratory Techniques / statistics & numerical data
  • Comorbidity
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / etiology
  • Coronavirus Infections / therapy*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Italy / epidemiology
  • Male
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / therapy*
  • Respiratory Therapy / methods
  • Respiratory Therapy / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Treatment Outcome