Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020.
Lazzerini, Marzia;
Sforzi, Idanna;
Trapani, Sandra;
Biban, Paolo;
Silvagni, Davide;
Villa, Giovanna;
Tibaldi, Jessica;
Bertacca, Luca;
Felici, Enrico;
Perricone, Giuseppina;
+33 more...Parrino, Roberta;
Gioè, Claudia;
Lega, Sara;
Conte, Mariasole;
Marchetti, Federico;
Magista, Annamaria;
Berlese, Paola;
Martelossi, Stefano;
Vaienti, Francesca;
Valletta, Enrico;
Mauro, Margherita;
Dall'Amico, Roberto;
Fasoli, Silvia;
Gatto, Antonio;
Chiaretti, Antonio;
Dragovic, Danica;
Pascolo, Paola;
Pilotto, Chiara;
Liguoro, Ilaria;
Miorin, Elisabetta;
Saretta, Francesca;
Trobia, Gian Luca;
Di Stefano, Antonella;
Orlandi, Azzurra;
Cardinale, Fabio;
Lubrano, Riccardo;
Testa, Alessia;
Binotti, Marco;
Moressa, Valentina;
Barbi, Egidio;
Armocida, Benedetta;
Mariani, Ilaria;
COVID-19 Italian Pediatric Study Network;
(2021)
Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020.
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 26 (14).
pp. 1-12.
ISSN 1025-496X
DOI: https://doi.org/10.2807/1560-7917.ES.2021.26.14.2001248
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BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe 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.ResultsAmong 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.ConclusionRecommendations 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.
