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Abstract

Background

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.

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2021-04-08
2024-12-21
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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
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Marzia+Lazzerini&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lazzerini Marzia</a>, <a href="/search?value1=Idanna+Sforzi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sforzi Idanna</a>, <a href="/search?value1=Sandra+Trapani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Trapani Sandra</a>, <a href="/search?value1=Paolo+Biban&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Biban Paolo</a>, <a href="/search?value1=Davide+Silvagni&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Silvagni Davide</a>, <a href="/search?value1=Giovanna+Villa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Villa Giovanna</a>, <a href="/search?value1=Jessica+Tibaldi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tibaldi Jessica</a>, <a href="/search?value1=Luca+Bertacca&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bertacca Luca</a>, <a href="/search?value1=Enrico+Felici&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Felici Enrico</a>, <a href="/search?value1=Giuseppina+Perricone&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Perricone Giuseppina</a>, <a href="/search?value1=Roberta+Parrino&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Parrino Roberta</a>, <a href="/search?value1=Claudia+Gio%C3%A8&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gioè Claudia</a>, <a href="/search?value1=Sara+Lega&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lega Sara</a>, <a href="/search?value1=Mariasole+Conte&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Conte Mariasole</a>, <a href="/search?value1=Federico+Marchetti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marchetti Federico</a>, <a href="/search?value1=Annamaria+Magista&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Magista Annamaria</a>, <a href="/search?value1=Paola+Berlese&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Berlese Paola</a>, <a href="/search?value1=Stefano+Martelossi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martelossi Stefano</a>, <a href="/search?value1=Francesca+Vaienti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vaienti Francesca</a>, <a href="/search?value1=Enrico+Valletta&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Valletta Enrico</a>, <a href="/search?value1=Margherita+Mauro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mauro Margherita</a>, <a href="/search?value1=Roberto+Dall%E2%80%99Amico&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dall’Amico Roberto</a>, <a href="/search?value1=Silvia+Fasoli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fasoli Silvia</a>, <a href="/search?value1=Antonio+Gatto&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gatto Antonio</a>, <a href="/search?value1=Antonio+Chiaretti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chiaretti Antonio</a>, <a href="/search?value1=Danica+Dragovic&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dragovic Danica</a>, <a href="/search?value1=Paola+Pascolo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pascolo Paola</a>, <a href="/search?value1=Chiara+Pilotto&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pilotto Chiara</a>, <a href="/search?value1=Ilaria+Liguoro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Liguoro Ilaria</a>, <a href="/search?value1=Elisabetta+Miorin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Miorin Elisabetta</a>, <a href="/search?value1=Francesca+Saretta&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Saretta Francesca</a>, <a href="/search?value1=Gian+Luca+Trobia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Trobia Gian Luca</a>, <a href="/search?value1=Antonella+Di+Stefano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Di Stefano Antonella</a>, <a href="/search?value1=Azzurra+Orlandi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Orlandi Azzurra</a>, <a href="/search?value1=Fabio+Cardinale&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cardinale Fabio</a>, <a href="/search?value1=Riccardo+Lubrano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lubrano Riccardo</a>, <a href="/search?value1=Alessia+Testa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Testa Alessia</a>, <a href="/search?value1=Marco+Binotti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Binotti Marco</a>, <a href="/search?value1=Valentina+Moressa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Moressa Valentina</a>, <a href="/search?value1=Egidio+Barbi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Barbi Egidio</a>, <a href="/search?value1=Benedetta+Armocida&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Armocida Benedetta</a>, <a href="/search?value1=Ilaria+Mariani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mariani Ilaria</a>, <a href="/search?value1=on+behalf+of+COVID-19+Italian+Pediatric+Study+Network&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of COVID-19 Italian Pediatric Study Network</a></span>. 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. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(14):pii=2001248. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.14.2001248" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.14.2001248</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 19 Jun 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 19 Nov 2020 </span> </p>
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