COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease?
Compared to adults, severe or fatal COVID-19 disease is much less common in children. However, a higher risk for progression has been reported in infants. Different pediatric COVID-19 severity scores are reported in the literature. Methods: Subjects under 90 days of age admitted to 35 Italian instit...
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MDPI AG
2022-10-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/10/2256 |
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| author | Daniele Dona’ Carlotta Montagnani Costanza Di Chiara Elisabetta Venturini Luisa Galli Andrea Lo Vecchio Marco Denina Nicole Olivini Eugenia Bruzzese Andrea Campana Roberta Giacchero Filippo Salvini Antonella Meini Matteo Ponzoni Sandra Trapani Elena Rossi Mary Haywood Lombardi Raffaele Badolato Luca Pierri Giulia Pruccoli Sara Rossin Claudia Colomba Salvatore Cazzato Ilaria Pacati Giangiacomo Nicolini Luca Pierantoni Sonia Bianchini Andrzej Krzysztofiak Silvia Garazzino Carlo Giaquinto Guido Castelli Gattinara on behalf of The Italian SITIP-SIP Pediatric SARS-CoV-2 Infection Study Group |
| author_facet | Daniele Dona’ Carlotta Montagnani Costanza Di Chiara Elisabetta Venturini Luisa Galli Andrea Lo Vecchio Marco Denina Nicole Olivini Eugenia Bruzzese Andrea Campana Roberta Giacchero Filippo Salvini Antonella Meini Matteo Ponzoni Sandra Trapani Elena Rossi Mary Haywood Lombardi Raffaele Badolato Luca Pierri Giulia Pruccoli Sara Rossin Claudia Colomba Salvatore Cazzato Ilaria Pacati Giangiacomo Nicolini Luca Pierantoni Sonia Bianchini Andrzej Krzysztofiak Silvia Garazzino Carlo Giaquinto Guido Castelli Gattinara on behalf of The Italian SITIP-SIP Pediatric SARS-CoV-2 Infection Study Group |
| author_sort | Daniele Dona’ |
| collection | DOAJ |
| description | Compared to adults, severe or fatal COVID-19 disease is much less common in children. However, a higher risk for progression has been reported in infants. Different pediatric COVID-19 severity scores are reported in the literature. Methods: Subjects under 90 days of age admitted to 35 Italian institutions for COVID-19 were included. The severity of COVID-19 was scored as mild/moderate or severe/critical following the classification reported in the literature by Venturini, Dong, Kanburoglu, and Gale. To assess the diagnostic accuracy of each classification system, we stratified all enrolled patients developing a posteriori severity score based on clinical presentation and outcomes and then compared all different scores analyzed. Results: We included 216 infants below 90 days of age. The most common symptom was fever, followed by coryza, poor feeding, cough, and gastrointestinal manifestations. According to Venturini, Dong, Kanburoglu, and Gale’s severity scores, 18%, 6%, 4.2%, and 29.6% of infants presented with severe/critical disease, respectively. A correlation analysis between these four scores and the a posteriori severity score assigned to all enrolled subjects was performed, and a crescent strength of correlation from Gale (R = 0.355, <i>p</i> < 0.001) to Venturini (R = 0.425, <i>p</i> < 0.001), Dong (R = 0.734, <i>p</i> < 0.001), and Kanburoglu (R = 0.859, <i>p</i> < 0.001) was observed. Conclusions: The percentage of infants with severe COVID-19 varies widely according to the score systems. A unique clinical score should be designed for neonates and infants with COVID-19. |
| first_indexed | 2024-03-09T19:22:58Z |
| format | Article |
| id | doaj.art-7e969b7118c747a7ac2bf4e849762fe2 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-09T19:22:58Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-7e969b7118c747a7ac2bf4e849762fe22023-11-24T03:10:17ZengMDPI AGViruses1999-49152022-10-011410225610.3390/v14102256COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease?Daniele Dona’0Carlotta Montagnani1Costanza Di Chiara2Elisabetta Venturini3Luisa Galli4Andrea Lo Vecchio5Marco Denina6Nicole Olivini7Eugenia Bruzzese8Andrea Campana9Roberta Giacchero10Filippo Salvini11Antonella Meini12Matteo Ponzoni13Sandra Trapani14Elena Rossi15Mary Haywood Lombardi16Raffaele Badolato17Luca Pierri18Giulia Pruccoli19Sara Rossin20Claudia Colomba21Salvatore Cazzato22Ilaria Pacati23Giangiacomo Nicolini24Luca Pierantoni25Sonia Bianchini26Andrzej Krzysztofiak27Silvia Garazzino28Carlo Giaquinto29Guido Castelli Gattinara30on behalf of The Italian SITIP-SIP Pediatric SARS-CoV-2 Infection Study GroupDivision of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, ItalyPediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, 50139 Florence, ItalyDivision of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, ItalyPediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, 50139 Florence, ItalyPediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, 50139 Florence, ItalyDepartment of Translational Medical Sciences, University of Naples Federico II, 80138 Naples, ItalyDepartment of Pediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children’s Hospital, 10126 Turin, ItalyOspedale Pediatrico Bambino Gesù, UOC Pediatria Multispecialistica, Fiumicino, 00050 Rome, ItalyDepartment of Translational Medical Sciences, University of Naples Federico II, 80138 Naples, ItalyOspedale Pediatrico Bambino Gesù, UOC Pediatria Multispecialistica, Fiumicino, 00050 Rome, ItalyUOC Pediatria-ASST Lodi, 26900 Lodi, ItalyDepartment of Pediatrics, Niguarda Hospital, 20162 Milan, ItalyDepartment of Experimental and Clinical Sciences, Pediatric Clinic, University of Brescia, 25121 Brescia, ItalyPediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova, ItalyPediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, 50139 Florence, ItalyUOC Pediatria-ASST Lodi, 26900 Lodi, ItalyOspedale Pediatrico Bambino Gesù, UOC Pediatria Multispecialistica, Fiumicino, 00050 Rome, ItalyDepartment of Experimental and Clinical Sciences, Pediatric Clinic, University of Brescia, 25121 Brescia, ItalyDepartment of Translational Medical Sciences, University of Naples Federico II, 80138 Naples, ItalyDepartment of Pediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children’s Hospital, 10126 Turin, ItalyPediatric Emergency Department, Department for Woman and Child Health, University of Padua, 35128 Padua, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, 90133 Palermo, ItalyPaediatric Unit, Department of Mother and Child Health, Salesi Children’s Hospital, 60123 Ancona, ItalyPaediatric Unit, Ospedale Bolognini ASST Bergamo Est, 24068 Seriate, ItalyPediatric Unit, San Martino Hospital, 32100 Belluno, ItalyMedical and Surgical Science Department, S Orsola University Hospital, 40138 Bologna, ItalyPediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06132 Perugia, ItalyPediatric and Infectious Diseases Unit, Academic Department, Bambino Gesù Pediatric Hospital, 00146 Rome, ItalyDepartment of Pediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children’s Hospital, 10126 Turin, ItalyDivision of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, ItalyUniversitarian-Hospital Department, Ospedale Bambino Gesù IRCCS, 00146 Rome, ItalyCompared to adults, severe or fatal COVID-19 disease is much less common in children. However, a higher risk for progression has been reported in infants. Different pediatric COVID-19 severity scores are reported in the literature. Methods: Subjects under 90 days of age admitted to 35 Italian institutions for COVID-19 were included. The severity of COVID-19 was scored as mild/moderate or severe/critical following the classification reported in the literature by Venturini, Dong, Kanburoglu, and Gale. To assess the diagnostic accuracy of each classification system, we stratified all enrolled patients developing a posteriori severity score based on clinical presentation and outcomes and then compared all different scores analyzed. Results: We included 216 infants below 90 days of age. The most common symptom was fever, followed by coryza, poor feeding, cough, and gastrointestinal manifestations. According to Venturini, Dong, Kanburoglu, and Gale’s severity scores, 18%, 6%, 4.2%, and 29.6% of infants presented with severe/critical disease, respectively. A correlation analysis between these four scores and the a posteriori severity score assigned to all enrolled subjects was performed, and a crescent strength of correlation from Gale (R = 0.355, <i>p</i> < 0.001) to Venturini (R = 0.425, <i>p</i> < 0.001), Dong (R = 0.734, <i>p</i> < 0.001), and Kanburoglu (R = 0.859, <i>p</i> < 0.001) was observed. Conclusions: The percentage of infants with severe COVID-19 varies widely according to the score systems. A unique clinical score should be designed for neonates and infants with COVID-19.https://www.mdpi.com/1999-4915/14/10/2256SARS-CoV-2COVID-19neonatesinfants |
| spellingShingle | Daniele Dona’ Carlotta Montagnani Costanza Di Chiara Elisabetta Venturini Luisa Galli Andrea Lo Vecchio Marco Denina Nicole Olivini Eugenia Bruzzese Andrea Campana Roberta Giacchero Filippo Salvini Antonella Meini Matteo Ponzoni Sandra Trapani Elena Rossi Mary Haywood Lombardi Raffaele Badolato Luca Pierri Giulia Pruccoli Sara Rossin Claudia Colomba Salvatore Cazzato Ilaria Pacati Giangiacomo Nicolini Luca Pierantoni Sonia Bianchini Andrzej Krzysztofiak Silvia Garazzino Carlo Giaquinto Guido Castelli Gattinara on behalf of The Italian SITIP-SIP Pediatric SARS-CoV-2 Infection Study Group COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease? Viruses SARS-CoV-2 COVID-19 neonates infants |
| title | COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease? |
| title_full | COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease? |
| title_fullStr | COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease? |
| title_full_unstemmed | COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease? |
| title_short | COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease? |
| title_sort | covid 19 in infants less than 3 months severe or not severe disease |
| topic | SARS-CoV-2 COVID-19 neonates infants |
| url | https://www.mdpi.com/1999-4915/14/10/2256 |
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