Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, 35128 Padua, Italy.
Pediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, 50139 Florence, Italy.
Viruses. 2022 Oct 14;14(10):2256. doi: 10.3390/v14102256.
Compared to adults, severe or fatal COVID-19 disease is much less common in children. However, a higher risk for progression has been reported in infants. Different pediatric COVID-19 severity scores are reported in the literature. Methods: Subjects under 90 days of age admitted to 35 Italian institutions for COVID-19 were included. The severity of COVID-19 was scored as mild/moderate or severe/critical following the classification reported in the literature by Venturini, Dong, Kanburoglu, and Gale. To assess the diagnostic accuracy of each classification system, we stratified all enrolled patients developing a posteriori severity score based on clinical presentation and outcomes and then compared all different scores analyzed. Results: We included 216 infants below 90 days of age. The most common symptom was fever, followed by coryza, poor feeding, cough, and gastrointestinal manifestations. According to Venturini, Dong, Kanburoglu, and Gale’s severity scores, 18%, 6%, 4.2%, and 29.6% of infants presented with severe/critical disease, respectively. A correlation analysis between these four scores and the a posteriori severity score assigned to all enrolled subjects was performed, and a crescent strength of correlation from Gale (R = 0.355, p < 0.001) to Venturini (R = 0.425, p < 0.001), Dong (R = 0.734, p < 0.001), and Kanburoglu (R = 0.859, p < 0.001) was observed. Conclusions: The percentage of infants with severe COVID-19 varies widely according to the score systems. A unique clinical score should be designed for neonates and infants with COVID-19.
与成年人相比,儿童患严重或致命 COVID-19 疾病的情况要少见得多。然而,有报道称婴儿的病情进展风险更高。文献中报道了不同的儿科 COVID-19 严重程度评分方法。方法:纳入了因 COVID-19 而入住意大利 35 家机构的 90 天以下的患儿。根据 Venturini、Dong、Kanburoglu 和 Gale 的文献报道的分类,将 COVID-19 的严重程度评为轻度/中度或重度/危重症。为评估每种分类系统的诊断准确性,我们根据临床表现和结局对所有入组患者进行了分层,以确定其严重程度,然后比较分析了所有不同的评分。结果:我们纳入了 216 名 90 天以下的婴儿。最常见的症状是发热,其次是流涕、喂养不良、咳嗽和胃肠道表现。根据 Venturini、Dong、Kanburoglu 和 Gale 的严重程度评分,分别有 18%、6%、4.2%和 29.6%的婴儿患有重度/危重症疾病。对这四种评分与所有入组患者的后发性严重程度评分进行了相关性分析,结果显示 Gale 评分(R = 0.355,p < 0.001)与 Venturini 评分(R = 0.425,p < 0.001)、Dong 评分(R = 0.734,p < 0.001)和 Kanburoglu 评分(R = 0.859,p < 0.001)的相关性逐渐增强。结论:根据评分系统的不同,患有严重 COVID-19 的婴儿比例差异很大。对于患有 COVID-19 的新生儿和婴儿,应该设计一个独特的临床评分系统。