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 characteristics of pediatric SARS-CoV-2 infection, focusing on risk factors for complicated and critical disease. Methods: The present multicenter Italian study was 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 from March 2020. Results: 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. Age was inversely related to hospital admission ( p < 0.01) and linearly to length of stay ( p = 0.014). One hundred forty-nine children (19.6%) developed complications. Comorbidities were risk factors for complications ( p < 0.001). Viral coinfections, underlying clinical conditions, age 5–9 years and lymphopenia were statistically related to ICU admission ( p < 0.05). Conclusions: Complications of COVID-19 in children are related to comorbidities and increase with age. Viral co-infections are additional risk factors for disease progression and multisystem inflammatory syndrome temporarily related to COVID-19 (MIS-C) for ICU admission.
【저자키워드】 COVID-19, SARS-COV-2 infection, children, MIS-C, Multisystem inflammatory syndrome, 【초록키워드】 Treatment, Infectious diseases, Hospitalized, pediatric, hospital, Comorbidity, Symptom, risk factor, lymphopenia, Disease progression, Characteristics, symptomatic, Fever, therapeutic, Co-infection, ICU admission, Complication, complications, age, epidemiological, Hospital admission, multicenter, Critical disease, Inflammatory, Society, subject, median age, syndrome, clinical conditions, Italian, enrolled, promoted, statistically, coordinating center, IQR, Italian study, 【제목키워드】 SARS-CoV-2, multicenter study, clinical, Factor, Italian, Result,