ABSTRACT
Background: Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear and optimal treatment is debated. The objective of our study was to investigate epidemiological, clinical and therapeutic aspects of SARS-CoV-2 infection in infants, children and adolescents, focusing on risk factors for complicated and critical disease.Methods: The present study is a multicenter Italian study promoted by the Italian Society of Pediatric Infectious Diseases, involving both pediatric hospitals and general pediatricians/family doctors. All subjects under 18 years of age with documented SARS-CoV-2 infection and referred to the coordinating center were enrolled starting from March 2020. An adequate follow-up to outline outcome was required (at least 2 weeks).Findings: As of 15 September 2020, 759 children were enrolled (median age 7.2 years, IQR 1.4;12.4). Among the 688 symptomatic children, fever was the most common symptom (81.9%). Barely 47% of children were hospitalized for COVID-19, with a median hospital stay of 6 days (IQR 4;10). Age was inversely related to hospital admission (p Mycoplasma pneumoniae co-infections, underlying clinical conditions, age between 5 and 9 years and lymphopenia were statistically related to ICU admission (p< 0.05). Multisystem inflammatory syndrome temporarily related to COVID-19 (MIS-C) was diagnosed in 30 children (3.9%). All but three children recovered.Interpretation: Complications of COVID-19 in children are related to the presence of co-morbidities. The length of hospital stay and the risk of complications increase with age. Viral co-infections are additional risk factors for disease progression and high CRP levels and lymphopenia may be predictive markers of severe clinical pictures. MIS-C is a risk factor for ICU admission. Outside MIS-C, most children with COVID-19 require only supportive therapy.Funding Statement: None.Declaration of Interests: None.Ethics Approval Statement: The study received ethical approval on 24 March 2020 (protocol number 0031296) and data collection was allowed by written consent of at least one parent.
Subject(s)
COVID-19 , Communicable DiseasesABSTRACT
Background: Amount of parenchymal involvement in patients with interstitial pneumonia Covid-19 related, seems to be associated with a worse prognosis. Nowadays 3D reconstruction imaging is expanding its role in clinical medical practice. We aimed to use 3D lung reconstruction of a young lady affected by Sars-CoV2 infection and interstitial pneumonia, to better visualize, and quantitatively assess the parenchymal involvement. Methods: Volumetric Chest CT scan was performed in a 15 years old girl with interstitial lung pneumonia, Sars-CoV2 infection related. 3D modeling of the lungs, with differentiation of healthy and affected parenchymal area were obtained by using multiple software. Results: 3D reconstruction imaging allowed us to quantify the lung parenchyma involved, Self-explaining 3D images, useful for the understanding, and discussion of the clinical case were also obtained. Conclusions: Quantitative Assessment of Parenchymal Involvement Using 3D Lung Model in Covid-19 Infection is feasible and it provides information which could play a role in the management and risk stratification of these patients.