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3. Impact of early candidemia on the long-term outcome of allogeneic hematopoietic stem cell transplant in non-leukemic patients: an outcome analysis on behalf of IDWP–EBMT

Author

Cesaro, Simone, Tridello, Gloria, Knelange, Nina Simone, Blijlevens, Nicole, Martin, Murray, Snowden, John A., Malladi, Ram, Ljungman, Per, Deconinck, Eric, Gedde-Dahl, Tobias, Byrne, Jennifer, Xhaard, Alienor, Chevallier, Patrice, Maertens, Johan, Zuckerman, Tsila, Lioure, Bruno, Petersen, Eefke, Cornelissen, Jan J., Arcese, William, Blaise, Didier, Milpied, Noel, Cahn, Jean Yves, Aljurf, Mahmoud, de Wreede, Liesbeth, Mauro, Margherita, de la Camara, Rafael, Averbuch, Diana, Mikulska, Malgorzata, and Styczynski, Jan

Published
2021
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4. Long-term outcome after allogeneic hematopoietic stem cell transplantation for Shwachman–Diamond syndrome: a retrospective analysis and a review of the literature by the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (SAAWP-EBMT)

Author

Cesaro, Simone, Pillon, Marta, Sauer, Martin, Smiers, Frans, Faraci, Maura, de Heredia, Cristina Diaz, Wynn, Robert, Greil, Johann, Locatelli, Franco, Veys, Paul, Uyttebroeck, Anne, Ljungman, Per, Chevalier, Patrice, Ansari, Marc, Badell, Isabel, Güngör, Tayfun, Salim, Rahuman, Tischer, Johanna, Tecchio, Cristina, Russell, Nigel, Chybicka, Alicja, Styczynski, Jan, Krivan, Gergely, Smith, Owen, Stein, Jerry, Afanasyev, Boris, Pochon, Cécile, Menconi, Maria Cristina, Bosman, Paul, Mauro, Margherita, Tridello, Gloria, de Latour, Regis Peffault, and Dufour, Carlo

Published
2020
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8. Inflammatory status in pediatric sickle cell disease: Unravelling the role of immune cell subsets

Author

Marchesani, Silvio, primary, Bertaina, Valentina, additional, Marini, Olivia, additional, Cossutta, Matilde, additional, Di Mauro, Margherita, additional, Rotulo, Gioacchino Andrea, additional, Palma, Paolo, additional, Sabatini, Letizia, additional, Petrone, Maria Isabella, additional, Frati, Giacomo, additional, Monteleone, Giulia, additional, Palumbo, Giuseppe, additional, and Ceglie, Giulia, additional

Published
2023
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10. Correction: Long-term outcome after allogeneic hematopoietic stem cell transplantation for Shwachman–Diamond syndrome: a retrospective analysis and a review of the literature by the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (SAAWP-EBMT)

Author

Cesaro, Simone, Pillon, Marta, Sauer, Martin, Smiers, Frans, Faraci, Maura, de Heredia, Cristina Diaz, Wynn, Robert, Greil, Johann, Locatelli, Franco, Veys, Paul, Uyttebroeck, Anne, Ljungman, Per, Chevalier, Patrice, Ansari, Marc, Badell, Isabel, Güngör, Tayfun, Salim, Rahuman, Tischer, Johanna, Tecchio, Cristina, Russell, Nigel, Chybicka, Alicja, Styczynski, Jan, Krivan, Gergely, Smith, Owen, Stein, Jerry, Afanasyev, Boris, Pochon, Cécile, Menconi, Maria Cristina, Bosman, Paul, Mauro, Margherita, Tridello, Gloria, de Latour, Regis Peffault, and Dufour, Carlo

Published
2020
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12. Outcome and Risk Factors of Febrile Episodes Treated with Broad Spectrum Antibiotics and Polyclonal IgM–Enriched Immunoglobulin in Pediatric Oncology Hematology Patients: A Retrospective Study

Author

Abram, Nicoletta, additional, Baretta, Valentina, additional, Mercolini, Federico, additional, De Bortoli, Massimiliano, additional, Chinello, Matteo, additional, Balter, Rita, additional, Bonetti, Elisa, additional, Zaccaron, Ada, additional, Vitale, Virginia, additional, Caddeo, Giulia, additional, Mauro, Margherita, additional, Battisti, Laura, additional, Tridello, Gloria, additional, and Cesaro, Simone, additional

Published
2021
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13. Echocardiographic Evaluation in Paediatric Sickle Cell Disease Patients: A Pilot Study.

Author

Sabatini, Letizia, Chinali, Marcello, Franceschini, Alessio, Di Mauro, Margherita, Marchesani, Silvio, Fini, Francesca, Arcuri, Giorgia, Lodi, Mariachiara, Palumbo, Giuseppe, and Ceglie, Giulia

Subjects
SICKLE cell anemia, CHILD patients, LEFT ventricular hypertrophy, ECHOCARDIOGRAPHY, LEFT heart atrium
Abstract

Cardiovascular involvement has a great impact on morbidity and mortality in sickle cell disease (SCD). Currently, few studies are available regarding the paediatric setting and, moreover, current guidelines for the echocardiogram screening program in the asymptomatic paediatric population are controversial. We performed a retrospective observational monocentric study on 64 SCD patients (37 male and 27 female, median age 10) at the Bambino Gesù Childrens' Hospital, who had undergone a routine transthoracic echocardiogram. In total, 46 (72%) patients had at least one cardiac abnormality. Left atrial dilatation (LAD) was present in 41 (65%) patients and left ventricular hypertrophy (LVH) was found in 29 (45%) patients. Patients with LAD showed lower median haemoglobin levels (p = 0.009), and a higher absolute reticulocyte count (p = 0.04). LVH was negatively correlated with the median haemoglobin value (p = 0.006) and positively with the reticulocyte count (p = 0.03). Moreover, we found that patients with cardiac anomalies had higher transfusion needs and a lower frequency of pain crises. In our setting, cardiac involvement has a high prevalence in the paediatric cohort and seems to be associated with specific laboratory findings, and with a specific clinical phenotype characterized by complications related to high haemodynamic load. [ABSTRACT FROM AUTHOR]

Published
2023
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15. Characteristics and risk factors for SARS-CoV-2 among children in Italy: a cross-sectional study in 20 pediatric centers

Author

Lazzerini, Marzia, primary, Sforzi, Idanna, additional, Trapani, Sandra, additional, Biban, Paolo, additional, Silvagni, Davide, additional, Mariani, Ilaria, additional, Villa, Giovanna, additional, Tibaldi, Jessica, additional, Bertacca, Luca, additional, Felici, Enrico, additional, Perricone, Giuseppina, additional, Parrino, Roberta, additional, Gioè, Claudia, additional, Lega, Sara, additional, Conte, Mariasole, additional, Marchetti, Federico, additional, Magista, Annamaria, additional, Berlese, Paola, additional, Martelossi, Stefano, additional, Vaienti, Francesca, additional, Valletta, Enrico, additional, Mauro, Margherita, additional, Dall’Amico, Roberto, additional, Fasoli, Silvia, additional, Gatto, Antonio, additional, Chiaretti, Antonio, additional, Dragovic, Danica, additional, Pascolo, Paola, additional, Pilotto, Chiara, additional, Liguoro, Ilaria, additional, Miorin, Elisabetta, additional, Saretta, Francesca, additional, Trobia, Gianluca, additional, Stefano, Antonella Di, additional, Orlandi, Azzurra, additional, Cardinale, Fabio, additional, Lubrano, Riccardo, additional, Testa, Alessia, additional, Binotti, Marco, additional, Moressa, Valentina, additional, Barbi, Egidio, additional, and Armocida, Benedetta, additional

Published
2021
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17. The diagnostic pitfalls of mucormycosis

Author

Mauro, Margherita, primary, Lo Cascio, Giuliana, additional, Balter, Rita, additional, Zaccaron, Ada, additional, Bonetti, Elisa, additional, Vitale, Virgina, additional, Chinello, Matteo, additional, De Bortoli, Massimiliano, additional, Brazzarola, Paolo, additional, Bruno, Costanza, additional, and Cesaro, Simone, additional

Published
2020
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18. Acute Cervical Longitudinally Extensive Transverse Myelitis in a Child With Lipopolysaccharide-Responsive-Beige-Like-Anchor-Protein (LRBA) Deficiency: A New Complication of a Rare Disease

Author

Chinello, Matteo, primary, Mauro, Margherita, additional, Cantalupo, Gaetano, additional, Talenti, Giacomo, additional, Mariotto, Sara, additional, Balter, Rita, additional, De Bortoli, Massimiliano, additional, Vitale, Virginia, additional, Zaccaron, Ada, additional, Bonetti, Elisa, additional, Di Carlo, Daniela, additional, Barzaghi, Federica, additional, and Cesaro, Simone, additional

Published
2020
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20. Characteristics and Risk Factors for SARS-CoV-2 Among Children in Italy Tested in the Early Phase of the Pandemic: A Cross-Sectional Study

Author

Lazzerini, Marzia, primary, Sforzi, Idanna, additional, Trapani, Sandra, additional, Biban, Paolo, additional, Silvagni, Davide, additional, Mariani, Ilaria, additional, Villa, Giovanna, additional, Tibaldi, Jessica, additional, Bertacca, Luca, additional, Felici, Enrico, additional, Perricone, Giuseppina, additional, Parrino, Roberta, additional, Gioè, Claudia, additional, Lega, Sara, additional, Conte, Mariasole, additional, Marchetti, Federico, additional, Magista, Annamaria, additional, Berlese, Paola, additional, Martelossi, Stefano, additional, Vaienti, Francesca, additional, Valletta, Enrico, additional, Mauro, Margherita, additional, Dall’Amico, Roberto, additional, Fasoli, Silvia, additional, Gatto, Antonio, additional, Chiaretti, Antonio, additional, Dragovic, Danica, additional, Pascolo, Paola, additional, Pilotto, Chiara, additional, Liguoro, Ilaria, additional, Miorin, Elisabetta, additional, Saretta, Francesca, additional, Trobia, Gian Luca, additional, Di Stefano, Antonella, additional, Orlandi, Azzurra, additional, Cardinale, Fabio, additional, Lubrano, Riccardo, additional, Testa, Alessia, additional, Binotti, Marco, additional, Barbi, Egidio, additional, and Armocida, Benedetta, additional

Published
2020
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25. Pure Red Cell Aplasia (PRCA) and Cerebellar Hypoplasia as Atypical Features of Polyglandular Autoimmune Syndrome Type I (APS-1): Two Sisters With the Same AIRE Mutation but Different Phenotypes

Author

Chinello, Matteo, primary, Mauro, Margherita, additional, Cantalupo, Gaetano, additional, Balter, Rita, additional, De Bortoli, Massimiliano, additional, Vitale, Virginia, additional, Zaccaron, Ada, additional, Bonetti, Elisa, additional, Gaudino, Rossella, additional, Fiorini, Elena, additional, and Cesaro, Simone, additional

Published
2019
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26. ALPS-Like Phenotype Caused by ADA2 Deficiency Rescued by Allogeneic Hematopoietic Stem Cell Transplantation

Author

Barzaghi, Federica, primary, Minniti, Federica, additional, Mauro, Margherita, additional, Bortoli, Massimiliano De, additional, Balter, Rita, additional, Bonetti, Elisa, additional, Zaccaron, Ada, additional, Vitale, Virginia, additional, Omrani, Maryam, additional, Zoccolillo, Matteo, additional, Brigida, Immacolata, additional, Cicalese, Maria Pia, additional, Degano, Massimo, additional, Hershfield, Michael S., additional, Aiuti, Alessandro, additional, Bondarenko, Anastasiia V., additional, Chinello, Matteo, additional, and Cesaro, Simone, additional

Published
2019
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27. Venoocclusive disease due to chemotherapy for pediatric acute lymphoblastic leukemia is associated with increased levels of plasminogen-activator inhibitor-1

Author

Mauro, Margherita, primary, Saggiorato, Graziella, additional, Sartori, Maria Teresa, additional, Gallo, Giuseppe, additional, De Bortoli, Massimiliano, additional, Bonetti, Elisa, additional, Zaccaron, Ada, additional, Vitale, Virginia, additional, Balter, Rita, additional, Chinello, Matteo, additional, and Cesaro, Simone, additional

Published
2018
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31. Sex Steroid Binding Protein Is a Negative Modulator of Estrogen‐induced Breast Cancer Cell Growtha

Author

FRAIRIA, ROBERTO, primary, FORTUNATI, NICOLETTA, additional, FAZZARI, ANNAMARIA, additional, FISSORE, FEDERICA, additional, COMBA, ALESSANDRA, additional, BECCHIS, MARZIA, additional, CATALANO, MARIA GRAZIELLA, additional, BENEDUSI‐PAGLIANO, ELISABETTA, additional, BERTA, LAURA, additional, MAURO, MARGHERITA, additional, and GAIDANO, GIANPIERO, additional

Published
1996
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33. Outcome and Risk Factors of Febrile Episodes Treated with Broad Spectrum Antibiotics and Polyclonal IgM–Enriched Immunoglobulin in Pediatric Oncology Hematology Patients: A Retrospective Study.

Author

Abram, Nicoletta, Baretta, Valentina, Mercolini, Federico, De Bortoli, Massimiliano, Chinello, Matteo, Balter, Rita, Bonetti, Elisa, Zaccaron, Ada, Vitale, Virginia, Caddeo, Giulia, Mauro, Margherita, Battisti, Laura, Tridello, Gloria, and Cesaro, Simone

Subjects
*NEONATAL sepsis, *PEDIATRIC oncology, *PEDIATRIC hematology, *HEMATOPOIETIC stem cell transplantation, *CANCER patients, *ANTIBIOTICS
Abstract

Objective  Preparations with high-titer immunoglobulin-M (HT-IgM) have been used to treat neonatal and adult sepsis as adjuvant to antibiotics. Limited data are available of this use in pediatric oncohematological patients. We retrospectively assessed the characteristics and outcome of febrile episodes treated with broad-spectrum antibiotics and HT-IgM. Methods  This study included febrile episodes diagnosed after chemotherapy or hematopoietic stem cell transplantation (HSCT) treated with antibiotics and HT-IgM. Study period was from January 2011 to March 2019. Results  Seventy febrile episodes in 63 patients were eligible. In 40% of episodes (n  = 28), blood cultures identified a causative organism: Gram-negative (n  = 15), Gram-positive (n  = 8), polybacterial (n  = 4), fungi (n  = 1). Twenty-six percent of Gram-negatives were extend spectrum β-lactamase (ESBL)-producers. In 44% of episodes, a deep-organ localization was present, mostly pulmonary. Severe or profound neutropenia, hypotension, and hypoxemia were present in 89, 26, and 21% of episodes, respectively; 20% of episodes required intensive care and 20% of episodes required the use of inotropes. Overall, 90-day mortality was 13% and infection-attributable mortality resulted 8.6%. More than half of the patients received HT-IgM within 24 hours from fever onset. HT-IgM-related allergic reactions occurred in three episodes. Risk factors for 90-day mortality were as follows: hypotension and hypoxemia at fever presentation, admission to intensive care unit (ICU), use of inotropes, presence of deep-organ infection, and escalation of antibiotic therapy within 5 days. Conclusion  The combination of broad-spectrum antibiotics and HT-IgM was feasible, tolerated, and promising, being associated with a limited infectious mortality. Further prospective controlled studies are needed to assess the efficacy of this combination over a standard antibiotic approach. [ABSTRACT FROM AUTHOR]

Published
2022
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34. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020

Author

Francesca Saretta, Marco Binotti, Idanna Sforzi, Egidio Barbi, Chiara Pilotto, Antonio Gatto, Valentina Moressa, Fabio Cardinale, Enrico Valletta, Alessia Testa, Benedetta Armocida, Marzia Lazzerini, Silvia Fasoli, Stefano Martelossi, Antonella Di Stefano, Federico Marchetti, Margherita Mauro, Ilaria Mariani, Paola Pascolo, Davide Silvagni, Mariasole Conte, Roberta Parrino, Giovanna Villa, Sandra Trapani, Francesca Vaienti, Annamaria Magista, Giuseppina Perricone, Ilaria Liguoro, Elisabetta Miorin, Enrico Felici, Jessica Tibaldi, Paola Berlese, Sara Lega, Gian Luca Trobia, Azzurra Orlandi, Claudia Gioè, Luca Bertacca, Roberto Dall'Amico, Riccardo Lubrano, Danica Dragovic, Antonio Chiaretti, Paolo Biban, Lazzerini, Marzia, Sforzi, Idanna, Trapani, Sandra, Biban, Paolo, Silvagni, Davide, Villa, Giovanna, Tibaldi, Jessica, Bertacca, Luca, Felici, Enrico, Perricone, Giuseppina, Parrino, Roberta, Gioè, Claudia, Lega, Sara, Conte, Mariasole, Marchetti, Federico, Magista, Annamaria, Berlese, Paola, Martelossi, Stefano, Vaienti, Francesca, Valletta, Enrico, Mauro, Margherita, Dall'Amico, Roberto, Fasoli, Silvia, Gatto, Antonio, Chiaretti, Antonio, Dragovic, Danica, Pascolo, Paola, Pilotto, Chiara, Liguoro, Ilaria, Miorin, Elisabetta, Saretta, Francesca, Trobia, Gian Luca, Di Stefano, Antonella, Orlandi, Azzurra, Cardinale, Fabio, Lubrano, Riccardo, Testa, Alessia, Binotti, Marco, Moressa, Valentina, Barbi, Egidio, Armocida, Benedetta, and Mariani, Ilaria

Subjects
Male, medicine.medical_specialty, Adolescent, Epidemiology, Cross-sectional study, children, COVID-19, Italy, risk factors, Anosmia, Disease, 03 medical and health sciences, 0302 clinical medicine, COVID-19 Testing, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Infant, Newborn, Risk Factors, Pandemics, 030225 pediatrics, Virology, Intensive care, Internal medicine, medicine, 030212 general & internal medicine, Preschool, Cross-Sectional Studie, business.industry, Risk Factor, Research, Public Health, Environmental and Occupational Health, Odds ratio, Ageusia, Newborn, Confidence interval, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, medicine.symptom, business, Human
Abstract

Background Very few studies describe factors associated with COVID-19 diagnosis in children. Aim We here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy. Methods We included cases aged 0–18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19. Results Among 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52–90.55; p Conclusion Recommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.

Published
2021

35. ALPS-Like Phenotype Caused by ADA2 Deficiency Rescued by Allogeneic Hematopoietic Stem Cell Transplantation

Author

Federica Barzaghi, Federica Minniti, Margherita Mauro, Massimiliano De Bortoli, Rita Balter, Elisa Bonetti, Ada Zaccaron, Virginia Vitale, Maryam Omrani, Matteo Zoccolillo, Immacolata Brigida, Maria Pia Cicalese, Massimo Degano, Michael S. Hershfield, Alessandro Aiuti, Anastasiia V. Bondarenko, Matteo Chinello, Simone Cesaro, Barzaghi, Federica, Minniti, Federica, Mauro, Margherita, Bortoli, Massimiliano De, Balter, Rita, Bonetti, Elisa, Zaccaron, Ada, Vitale, Virginia, Omrani, Maryam, Zoccolillo, Matteo, Brigida, Immacolata, Cicalese, Maria Pia, Degano, Massimo, Hershfield, Michael S., Aiuti, Alessandro, Bondarenko, Anastasiia V., Chinello, Matteo, and Cesaro, Simone

Subjects
lcsh:Immunologic diseases. Allergy, 0301 basic medicine, Transplantation Conditioning, Adenosine Deaminase, medicine.medical_treatment, Immunology, ALPS, Apoptosis, Case Report, Hematopoietic stem cell transplantation, Disease, Neutropenia, medicine.disease_cause, ADA2, Autoimmunity, 03 medical and health sciences, 0302 clinical medicine, Granulocyte Colony-Stimulating Factor, ADA2 deficiency, medicine, Humans, Transplantation, Homologous, neutropenia, Immunology and Allergy, fas Receptor, Immunodeficiency, business.industry, Autoimmune Lymphoproliferative Syndrome, autoimmunity, Hematopoietic Stem Cell Transplantation, CECR1, medicine.disease, 030104 developmental biology, medicine.anatomical_structure, HSCT, immunodeficiency, Child, Preschool, Autoimmune lymphoproliferative syndrome, Autoimmune neutropenia, Intercellular Signaling Peptides and Proteins, Female, Bone marrow, lcsh:RC581-607, Unrelated Donors, business, 030215 immunology
Abstract

Adenosine deaminase 2 (ADA2) deficiency is an auto-inflammatory disease due to mutations in cat eye syndrome chromosome region candidate 1 (CECR1) gene, currently named ADA2. The disease has a wide clinical spectrum encompassing early-onset vasculopathy (targeting skin, gut and central nervous system), recurrent fever, immunodeficiency and bone marrow dysfunction. Different therapeutic options have been proposed in literature, but only steroids and anti-cytokine monoclonal antibodies (such as tumor necrosis factor inhibitor) proved to be effective. If a suitable donor is available, hematopoietic stem cell transplantation (HSCT) could be curative. Here we describe a case of ADA2 deficiency in a 4-year-old Caucasian girl. The patient was initially classified as autoimmune neutropenia and then she evolved toward an autoimmune lymphoproliferative syndrome (ALPS)-like phenotype. The diagnosis of ALPS became uncertain due to atypical clinical features and normal FAS-induced apoptosis test. She was treated with G-CSF first and subsequently with immunosuppressive drugs without improvement. Only HSCT from a 9/10 HLA-matched unrelated donor, following myeloablative conditioning, completely solved the clinical signs related to ADA2 deficiency. Early diagnosis in cases presenting with hematological manifestations, rather than classical vasculopathy, allows the patients to promptly undergo HSCT and avoid more severe evolution. Finally, in similar cases highly suspicious for genetic disease, it is desirable to obtain molecular diagnosis before performing HSCT, since it can influence the transplant procedure. However, if HSCT has to be performed without delay for clinical indication, related donors should be excluded to avoid the risk of relapse or partial benefit due to a hereditary genetic defect.

Published
2019

36. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020.

Author

Lazzerini M, Sforzi I, Trapani S, Biban P, Silvagni D, Villa G, Tibaldi J, Bertacca L, Felici E, Perricone G, Parrino R, Gioè C, Lega S, Conte M, Marchetti F, Magista A, Berlese P, Martelossi S, Vaienti F, Valletta E, Mauro M, Dall'Amico R, Fasoli S, Gatto A, Chiaretti A, Dragovic D, Pascolo P, Pilotto C, Liguoro I, Miorin E, Saretta F, Trobia GL, Di Stefano A, Orlandi A, Cardinale F, Lubrano R, Testa A, Binotti M, Moressa V, Barbi E, Armocida B, and Mariani I

Subjects
Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Infant, Newborn, Italy epidemiology, Male, Risk Factors, COVID-19 diagnosis, COVID-19 epidemiology, COVID-19 Testing, Pandemics
Abstract

BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.

Published
2021
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