TY - JOUR
T1 - COVID-19 in 17 Italian Pediatric Emergency Departments
AU - CONFIDENCE RESEARCH GROUP
AU - Parri, Niccolò
AU - Lenge, Matteo
AU - Cantoni, Barbara
AU - Arrighini, Alberto
AU - Romanengo, Marta
AU - Urbino, Antonio
AU - Da Dalt, Liviana
AU - Verdoni, Lucio
AU - Giacchero, Roberta
AU - Lanari, Marcello
AU - Musolino, Anna Maria
AU - Biban, Paolo
AU - La Fauci, Giovanna
AU - Pilotto, Chiara
AU - Buonsenso, Danilo
AU - Chiossi, Massimo
AU - Agostiniani, Rino
AU - Plebani, Anna
AU - Zampogna, Stefania
AU - Barbieri, Maria Antonietta
AU - De Masi, Salvatore
AU - Agostoni, Carlo
AU - Masi, Stefano
N1 - Publisher Copyright:
Copyright © 2020 by the American Academy of Pediatrics.
Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2020/12/1
Y1 - 2020/12/1
N2 - 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.
AB - 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.
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U2 - 10.1542/peds.2020-1235
DO - 10.1542/peds.2020-1235
M3 - Article
C2 - 32968031
AN - SCOPUS:85097112731
VL - 146
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 6
M1 - e20201235
ER -