Characteristics and Risk Factors for SARS-CoV-2 Among Children in Italy Tested in the Early Phase of the Pandemic: A Cross-Sectional Study

Lazzerini, Marzia; Sforzi, Idanna; Trapani, Sandra; Biban, Paolo; Silvagni, Davide; Mariani, Ilaria; Villa, Giovanna; Tibaldi, Jessica; Bertacca, Luca; Felici, Enrico; Perricone, Giuseppina; Parrino, Roberta; Gioè, Claudia; Lega, Sara; Conte, Mariasole; Marchetti, Federico; Magistà, Annamaria; Berlese, Paola; Martelossi, Stefano; Vaienti, Francesca; Valletta, Enrico; Mauro, Margherita; Dall’Amico, Roberto; Fasoli, Silvia; Gatto, Antonio; Chiaretti, Antonio; Dragovic, Danica; Pascolo, Paola; Pozzi, Chiara; Liguoro, Ilaria; Miorin, Elisabetta; Saretta, Francesca; Trobia, Gian Luca; Stefano, Antonella Di; Orlandi, Azzurra; Cardinale, Fabio; Lubrano, Riccardo; Testa, Alessia; Binotti, Marco; Barbi, Egidio; Armocida, Benedetta

doi:10.2139/ssrn.3631265

Cited by 5 publications

(11 citation statements)

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“…Previous studies have reported that many children with COVID-19 are asymptomatic or have milder symptoms than adults and generally have a good prognosis 4,6,13,17) and these findings are consistent with our results. A small proportion of children progressed to severe illness requiring intensive care and even death.…”

Section: In This Study the Mean Interval Between Diagnosis And The First Measurement Of Ct Valuessupporting

confidence: 93%

“…Ct values of three target genes were significantly higher in the patients who experienced viral rebounds than in those who did not (Table 3, (Table 3). Many previous studies have reported that most children with COVID-19 are infected through contact with infected family members, 12,13) which is consistent with our results. Our results showed that the proportion of transmission within family was highest when only mother was infected, which might be because mothers usually have close and prolonged contacts with their children.…”

Section: Viral Load and Viral Rebound During Sars-cov-2 Infectionsupporting

confidence: 93%

“…Most previous studies which reported the dynamics of viral load in children with COVID-19 included the pediatric patients who were treated with antiviral agent like interferon-α regardless of disease severity according to each nation's guidelines. 12,13,[30][31][32][33][34][35] Although the role of antiviral therapies in COVID-19 is not determined yet, 36) as in SARS-CoV or other virus infection, interferon-α might affect the dynamics of viral load in the children with COIVD-19. 37) In our study, all but 1 patient did not require any antiviral treatment, and we were able to show the natural course of viral load in the asymptomatic or mild pediatric cases.…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

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Viral load and rebound in children with coronavirus disease 2019 during the first outbreak in Daegu city

et al. 2021

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Background: Viral load and shedding duration are highly associated with the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, limited studies have reported on viral load or shedding in children and adolescents infected with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Purpose: This study aimed to investigate the natural course of viral load in asymptomatic or mild pediatric cases.Methods: Thirty-one children (<18 years) with confirmed SARS-CoV-2 infection were hospitalized and enrolled in this study. Viral loads were evaluated in nasopharyngeal swab samples using real-time reverse transcription polymerase chain reaction (E, RdRp, N genes).Ct values were measured when patients met the clinical criteria to be released from quarantine.Results: The mean age of the patients was 9.8 years, 18 (58%) had mild disease, and 13 (42%) were asymptomatic. Most children were infected by adult family members, most commonly by their mothers. The most common symptoms were fever and sputum (26%), followed by cough and runny nose. Nine patients (29%) had a high or intermediate viral load (Ct value≤30) when they had no clinical symptoms. Viral load showed no difference between symptomatic and asymptomatic patients. Viral rebounds were found in 15 cases (48%), which contributed to prolonged viral detection. The mean duration of viral detection was 25.6 days.Viral loads were significantly lower in patients with viral rebounds than in those with no rebound (E, p=0.003; RdRp, p=0.01; N, p=0.02). Conclusion: Our study showed that many pediatric patients with COVID-19 experiencedA c c e p t e d A r t i c l e 3 viral rebound and showed viral detection for more than 3 weeks. Further studies are needed to investigate the relationship between viral rebound and infectiousness in COVID-19.

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Section: In This Study the Mean Interval Between Diagnosis And The First Measurement Of Ct Valuessupporting

confidence: 93%

Section: Viral Load and Viral Rebound During Sars-cov-2 Infectionsupporting

confidence: 93%

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

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Viral load and rebound in children with coronavirus disease 2019 during the first outbreak in Daegu city

et al. 2021

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“…Thus, we can assume that these results are biased towards signs and symptoms that the patient must be able to express. It is worth mentioning that the study from Lazzerini et al [17] reports some cases of anosmia and ageusia, and that study from Mak, et al [18] presents 3 case studies of adolescents (14, 15, and 17 years old) with these symptoms. They too hypothesize that the scarce number of children found to have anosmia/ageusia is due not to the fact that few children develop them, but to difficulty assessing them in younger patients [18].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Manifestations, Clinical Characteristics and Outcomes of COVID-19 in Adult and Pediatric Patients

Russo¹,

Pizuorno²,

Oskrochi³

et al. 2021

SOJMID

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Background: Italy was the first country in Europe to report a SARS-CoV-2 case. Since then, the country has suffered a large number of COVID-19 infections both in adults and children. This disease has been shown to lead to different outcomes in these two groups, which oftenpresent varying symptoms and comorbidities. Aim: Therefore, we aimed to evaluate the symptoms, comorbidities and laboratory values in adults and children. Methods: We present the characteristics of 1,324 adults and 563 pediatric COVID-19 Italian patients. The data was retrieved from studies published in Italy and found via PubMed and Google Scholar. Results: The virus appeared to affect adults more than children and men more than women, and to result in more severe outcomes in patients with abnormal laboratory values and a higher number of comorbidities. Adults are at higher risk for complications and death, and they usually present with fever, respiratory symptoms, cough, fatigue, diarrhea, myalgia, and/or loss of taste, smell, or appetite. Children usually have a milder disease progression and usually present with fever, cough, rhinorrhea, pharyngitis, sore throat, pneumonia, GI symptoms (diarrhea, vomiting, abdominal pain), fatigue, and dyspnea. Conclusion: Our findings support early reports that showed that SARS-CoV-2 is associated with more common asymptomatic cases and milder clinical outcome in children than in adults. Acute respiratory distress syndrome and Multisystem inflammatory syndrome in children (systemic vasculitis) are the most severe disease progressions for adults and children, respectively. Keywords: Coronavirus Disease-19; Pandemic; Gastrointestinal Manifestation; Italy; Adults; Pediatrics Abbreviations: COVID-19: Coronavirus Disease-19; GI: Gastrointestinal; RT-PCR: Real-time Polymerase Chain Reaction; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus-2

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“…Our clinical findings were compared with those observed in the other European cohorts of children presenting in the ED [13][14][15][16][17][18][19][20] as resulted by our scoping review (Table 2). Similar prevalence of symptoms was observed in all cohorts.…”

Section: Clinical Findings 331 Scoping Review Results: European Studi...mentioning

confidence: 99%

Symptom clusters helping the assessment of SARS-COV-2-infected children: Amiens cohort versus European data

et al. 2022

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Background: Since December 2019, the novel coronavirus (SARS-CoV-2) pandemic, caused >240 million cases and >5 million deaths. Given the current wider dissemination of pediatric cases, it is important to address questions regarding the clinical picture in children or if there are clinical patterns that may help us identify in an early stage what can be the prognosis and help clinicians with patient management. The study aimed to investigate in a French monocentric cohort and other European cohorts the presence of symptom clusterization and its possible connection to illness categories to help medical first-line screening and orientation in the pediatric emergency department (ED). Methods: We conducted a retrospective cohort study describing clinical, laboratory, and radiological characteristics of SARS-CoV-2-infected children admitted to pediatric ED to assess the presence of symptom clustering. A scoping review of the literature was performed to further investigate symptom clusters. Results: Of 1086 tested children, 48 tested positive to SARS-CoV-2. The clinical, laboratory, and radiological characteristics of our sample were fully described. Two distinct clusters of clinical phenotypes were identified as well as their potential association with illness categories in SARS-CoV-2-infected children. Comparison with similar European cohorts highlights how symptoms coming from the mucocutaneous-enteric, and the respiratory clusters are associated with a more severe clinical picture. Conclusions: This study promotes the importance to identify early prognostic patterns to help clinicians in the decision process, especially in COVID-19 pediatric patients.

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Characteristics and Risk Factors for SARS-CoV-2 Among Children in Italy Tested in the Early Phase of the Pandemic: A Cross-Sectional Study

Cited by 5 publications

References 0 publications

Viral load and rebound in children with coronavirus disease 2019 during the first outbreak in Daegu city

Viral load and rebound in children with coronavirus disease 2019 during the first outbreak in Daegu city

Gastrointestinal Manifestations, Clinical Characteristics and Outcomes of COVID-19 in Adult and Pediatric Patients

Symptom clusters helping the assessment of SARS-COV-2-infected children: Amiens cohort versus European data

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