COVID-19 in 17 Italian Pediatric Emergency Departments

CONFIDENCE RESEARCH GROUP, Niccolò Parri, Matteo Lenge, Barbara Cantoni, Alberto Arrighini, Marta Romanengo, Antonio Urbino, Liviana Da Dalt, Lucio Verdoni, Roberta Giacchero, Marcello Lanari, Anna Maria Musolino, Paolo Biban, Giovanna La Fauci, Chiara Pilotto, Danilo Buonsenso, Massimo Chiossi, Rino Agostiniani, Anna Plebani, Stefania ZampognaMaria Antonietta Barbieri, Salvatore De Masi, Carlo Agostoni, Stefano Masi

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Variability in presentation of children with coronavirus disease 2019 (COVID-19) is a challenge in emergency departments (EDs) in terms of early recognition, which has an effect on disease control and prevention. We describe a cohort of 170 children with COVID-19 and differences with the published cohorts. METHODS: Retrospective chart reviews on children (0-18 years) evaluated in 17 Italian pediatric EDs. RESULTS: In our cohort (median age of 45 months; interquartile range of 4 months-10.7 years), we found a high number of patients <1 year with COVID-19 disease. The exposure happened mainly (59%) outside family clusters; 22% had comorbidities. Children were more frequently asymptomatic (17%) or with mild diseases (63%). Common symptoms were cough (43%) and difficulty feeding (35%). Chest computed tomography, chest radiograph, and point-of-care lung ultrasound were used in 2%, 36%, and 8% of cases, respectively. Forty-three percent of patients were admitted because of their clinical conditions. The minimal use of computed tomography and chest radiograph may have led to a reduced identification of moderate cases, which may have been clinically classified as mild cases. CONCLUSIONS: Italian children evaluated in the ED infrequently have notable disease symptoms. For pediatrics, COVID-19 may have rare but serious and life-threatening presentations but, in the majority of cases, represents an organizational burden for the ED. These data should not lower the attention to and preparedness for COVID-19 disease because children may represent a source of viral transmission. A clinically driven classification, instead of a radiologic, could be more valuable in predicting patient needs and better allocating resources.

Original languageEnglish
Article numbere20201235
JournalPediatrics
Volume146
Issue number6
DOIs
Publication statusPublished - Dec 1 2020

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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