VERDI Project: SARS-coV2 variants Evaluation in pRegnancy and paeDIatrics cohorts
Published October 14, 2022 | Version v1
Journal article Open

COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease?

Creators

  • 1. Division of Pediatric Infectious Diseases, Department for Women's and Children's Health
  • 2. Pediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, 50139 Florence
  • 3. Pediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, 50139 Florence; Department of Health Sciences, University of Florence
  • 4. Department of Translational Medical Sciences, University of Naples Federico II
  • 5. Department of Pediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, 10126 Turin
  • 6. Ospedale Pediatrico Bambino Gesù, UOC Pediatria Multispecialistica, Fiumicino, 00050 Rome
  • 7. UOC Pediatria-ASST Lodi, 26900 Lodi
  • 8. Department of Pediatrics, Niguarda Hospital, 20162 Milan
  • 9. Department of Experimental and Clinical Sciences, Pediatric Clinic, University of Brescia, 25121 Brescia
  • 10. Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova
  • 11. Pediatric Emergency Department, Department for Woman and Child Health, University of Padua
  • 12. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo
  • 13. Paediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, 60123 Ancona
  • 14. Paediatric Unit, Ospedale Bolognini ASST Bergamo Est, 24068 Seriate
  • 15. Pediatric Unit, San Martino Hospital, 32100 Belluno
  • 16. Medical and Surgical Science Department, S Orsola University Hospital, 40138 Bologna
  • 17. Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06132 Perugia
  • 18. Pediatric and Infectious Diseases Unit, Academic Department, Bambino Gesù Pediatric Hospital, 00146 Rome
  • 19. Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua
  • 20. Universitarian-Hospital Department, Ospedale Bambino Gesù IRCCS, 00146 Rome

Description

Abstract: 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, p < 0.001) to Venturini (R = 0.425, p < 0.001), Dong (R = 0.734, p < 0.001), and Kanburoglu (R = 0.859, p < 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. 

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Additional details

Funding

VERDI – SARS-coV2 variants Evaluation in pRegnancy and paeDIatrics cohorts 101045989
European Commission