Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.
Department of Pediatrics, Community Pediatrics, Ravenna, Italy.
Eur J Pediatr. 2020 Aug;179(8):1315-1323. doi: 10.1007/s00431-020-03683-8. Epub 2020 Jun 3.
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.
关于欧洲儿童 COVID-19 的临床表现和结局的详细数据仍然缺乏。在这项描述性研究中,我们报告了在大流行的最初几个月里,意大利 10 个地区的 28 个中心(主要是医院)诊断出的 130 例确诊 COVID-19 的儿童。其中,67 例(51.5%)的亲属患有 COVID-19,34 例(26.2%)有合并症,最常见的是呼吸、心脏或神经肌肉慢性疾病。总体而言,98 例(75.4%)为无症状或轻症,11 例(8.5%)为中度疾病,11 例(8.5%)为重症疾病,9 例(6.9%)为危重症表现,婴儿低于 6 个月的患者患有危重症的风险显著增加(OR 5.6,95%CI 1.3 至 29.1)。75 例(57.7%)儿童住院,15 例(11.5%)需要一些呼吸支持,9 例(6.9%)在重症监护病房接受治疗。所有患者均康复。
这项针对 COVID-19 儿童的描述性病例系列研究,主要纳入了在医院水平登记的病例,表明 COVID-19 在某些儿科人群中可能有不容忽视的严重表现率,且合并症发生率相对较高。需要进一步研究以更好地了解特殊需求儿童 COVID-19 的临床表现和结局。
• 关于欧洲儿童 COVID-19 的临床表现和结局的证据有限,几乎没有关于重症病例特征和危险因素的证据。
• 在一项针对 130 例儿童的病例系列研究中,大多数在医院确诊,且合并症发生率相对较高(26.2%),约四分之三的患儿为无症状或轻症。• 然而,57.7%的患儿住院,11.5%需要一些呼吸支持,6.9%的患儿在重症监护病房接受治疗。