The Position paper of the Association of Italian Pediatric Hospitals (Aopi) focuses on the main peculiarities of the virus in the pediatric field, on the actions implemented in the first phase and on the proposals to initiate timely interventions in the subsequent phases, also in view of a possible “recovery autumnal of the pandemic “. Some important data emerge from the position paper.
With respect to the impact of the pandemic on adults, the pediatric field is characterized by the following characteristics:
The pediatric age (age range 0-18 years) represents a small proportion of the total number of confirmed cases: approximately 2.2% as of July 14, 2020 (5,318 cases out of 243,316 total cases). Of this population, 12.4% are aged less than or equal to 1 year, 18.5% are aged between 2 and 6 years and 69.0% between 7 and 17 years
Preliminary data from the Italian seroprevalence study conducted by ISTAT show, as of July 28, 2020, 6,887 cases of pediatric patients positive for SARS-CoV-2 (2.8% of all positive); in children aged 0 to 5 years, seroprevalence is lower (1.3%)
The average age of Covid-19 patients in pediatric age, according to a European study, is 5 years (April data), while an Italian study (February-May) reports an average age of 11 years, probably in in relation to the greater percentage of cases recorded in the adolescent age group in our country
Most children with Covid-19 (about 75%) do not have comorbidities
The hospitalization rate in children is high (about 65%), although a recent Italian study reports much lower rates (13.3%). The risk of hospitalization is inversely proportional to age: children under 12 months are at greater risk (36%) than older children (<13%). The risk of ICU admission is higher in the 2-6 year cohort
All the studies conducted so far on the pediatric population affected by Covid-19 have shown that the disease occurs more frequently in an asymptomatic or paucisymptomatic manner than in adults and the elderly population (respectively approximately 63% vs 44% and 27%), with rare complications and favorable outcome
- In symptomatic patients, fever is the most common clinical manifestation, followed by signs or symptoms of respiratory system involvement (cough, rhinitis, breathing difficulties)
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Pediatric mortality is low, less than 0.5%, compared to approximately 14% in the general population. - 24 September 2020. Italian Journal of Pediatrics. Treatment of children with COVID-19: position paper of the Italian Society of Pediatric Infectious Disease
A consensus statement was formulated after reviewing the available literature on pediatric treatment strategies for COVID-19 by the Steering and Scientific Committee of the Italian Society of Pediatric Infectious Diseases in collaboration with the Italian Society of Pediatrics. September 23, 2020. Pediatrics .
COVID-19 in 17 Italian Pediatric Emergency Departments
170 Italian children were examined and compared with the previously reported cohorts. The cohort has younger patients than the others and mainly exposed to non-relatives. Patients required few diagnostic resources.
- A clinically guided classification might be more useful when dealing with pediatric COVID-19, which, apart from rare presentations (Multisystem Inflammatory Syndrome), in most cases represents an organizational burden for the emergency room.
- September 15, 2020. Medicine (Kaunas). Clinical Characteristics of Asymptomatic and Symptomatic Pediatric Coronavirus Disease 2019 (COVID-19): A Systematic Review
Early detection of the disease in children is important in controlling the pandemic, as asymptomatic or slightly infected children can act as carriers. To date, there are limited studies describing the differences in clinical, laboratory and radiological characteristics between asymptomatic and symptomatic infection and between younger and older pediatric patients.
The objective of this study is to compare the characteristics between asymptomatic versus symptomatic pediatric patients and between the youngest and oldest 10-year-olds.