Severity of SARS-CoV-2 infection in a hospital population: a clinical comparison across age groups

• Main Authors: Chiara Rosazza (Author), Laura Alagna (Author), Alessandra Bandera (Author), Arianna Biffi (Author), Fabiana Ciciriello (Author), Andrea Gramegna (Author), Vincenzina Lucidi (Author), Paola Giovanna Marchisio (Author), Paola Medino (Author), Antonio Muscatiello (Author), Sara Uceda Renteria (Author), Carla Colombo (Author)
• Format: Book
• Published: BMC, 2023-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s13052-023-01485-w; 1824-7288
• Keywords: COVID-19; SARS-CoV-2 infection; Paediatric population; MIS-C; Outcome; Pediatrics; RJ1-570
• Source: Italian Journal of Pediatrics, Vol 49, Iss 1, Pp 1-8 (2023)

Abstract Background Children tend to have milder forms of COVID-19 than adults, however post-acute complications have been observed also in the paediatric population. In this study, we compared COVID-19-related outcomes and long-term complications between paediatric and adult patients infected by SARS-CoV-2. Methods The study is based on individuals enrolled from October 2020 to June 2021 in the DECO COVID-19 multicentre prospective study supported by the Italian Ministry of Health (COVID-2020-12371781). We included individuals with RT-PCR -confirmed SARS-CoV-2 infection, who were evaluated in the emergency department and/or admitted to COVID-dedicated wards. The severity of SARS-CoV-2 infection was compared across age groups (children/adolescents aged < 18 years, young/middle-aged adults aged 18-64 years and older individuals) through the relative risk (RR) of severe COVID-19. Severity was defined by: 1) hospitalization due to COVID-19 and/or 2) need or supplemental oxygen therapy. RR and corresponding 95% confidence intervals were estimated using log-binomial models. Results The study included 154 individuals, 84 (54.5%) children/adolescents, 50 (32.5%) young/middle-aged adults and 20 (13%) older adults. Compared to young/middle-aged adults the risk of hospitalization was lower among paediatric patients (RR: 0.49, 95% CI: 0.32-0.75) and higher among older adults (RR: 1.52, 95% CI: 1.12-2.06). The RR of supplemental oxygen was 0.12 (95% CI: 0.05-0.30) among children/adolescents and 1.46 (95% CI: 0.97-2.19) among older adults. Three children developed multisystem inflammatory syndrome (MIS-C), none was admitted to intensive care unit or reported post-acute Covid-19 complications. Conclusions Our study confirms that COVID-19 is less severe in children. MIS-C is a rare yet severe complication of SARS-CoV-2 infection in children and its risk factors are presently unknown.