Characteristics and risk factors of isolated and quarantined children and adolescents during the first wave of SARS-CoV-2 pandemic: A cross-sectional study in Modena, Northern Italy SARS-CoV-2 in Modena children

Main Article Content

Stefania Paduano https://orcid.org/0000-0003-3640-9177
Maria Chiara Facchini
Antonella Greco
Lucia Borsari
Valentina M. Mingrone
Stefano Tancredi
Elisabetta Fioretti
Giacomo Creola
Laura Iacuzio https://orcid.org/0000-0002-7271-1042
Giovanni Casaletti
Marco Vinceti https://orcid.org/0000-0002-0551-2473
Annalisa Bargellini https://orcid.org/0000-0002-7562-1472
Tommaso Filippini https://orcid.org/0000-0003-2100-0344

Keywords

adolescent, children, contact tracing, pandemic, public health, SARS-CoV-2

Abstract

Background and aim: In early 2020, SARS-CoV-2 was declared a pandemic by the WHO and Italy was one of the first and most severely affected country in Europe. Despite the global interest about COVID-19 pandemic, several aspects of this infection are still unclear, especially in pediatric population. This study aims to investigate the characteristics of the isolated or quarantined children and adolescents followed by the Public Health Department of the Italian province of Modena during the first wave of COVID-19.


Methods: The study population included all non-adult subjects aged 0-18 years who underwent isolation or quarantine during the first wave of SARS-CoV-2 pandemic from February 24 to June 18, 2020 in Modena province, Northern Italy.


Results: In Modena province, 1230 children and adolescents were isolated in case of SARS-CoV-2 infection (6.3%), or quarantined due to close contact with confirmed cases (88.7%) or travelling from a high-risk area (5.0%). Among 349 individuals who underwent swab testing, 294 (84.2%) reported close contact with an infected cohabiting relative and 158 (45.3%) were symptomatic. Among all tested subjects, 78 (22.4%) resulted positive, with a higher proportion of symptomatic subjects compared with the SARS-CoV-2-negative (78.2% vs. 35.8%). Fever was mostly present in SARS-CoV-2-positive children (48.7% vs. 12.6%). Both anosmia (58.3% vs. 41.7%) and dysgeusia (54.5% vs. 45.5%) had only slightly higher frequency in SARS-CoV-2-positive.


Conclusions: These findings allow to expand the knowledge regarding characteristics of non-adult subjects isolated or quarantined during the first wave of SARS-CoV-2 pandemic. (www.actabiomedica.it)

Downloads

Download data is not yet available.
Abstract 60 | PDF Downloads 34

References

1. Docea AO, Tsatsakis A, Albulescu D, et al. A new threat from an old enemy: Reemergence of coronavirus (Review). Int J Mol Med 2020; 45 (6): 1631-43. https://doi.org/10.3892/ijmm.2020.4555.
2. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; 382 (13): 1199-207. https://doi.org/10.1056/NEJMoa2001316.
3. WHO. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. (Accessed September 7, 2021)
4. CPD - Italian Civil Protection Department. COVID-19 data. https://github.com/pcm-dpc/COVID-19. (Accessed September 7, 2021).
5. Vinceti M, Filippini T, Rothman KJ, et al. SARS-CoV-2 infection incidence during the first and second COVID-19 waves in Italy. Environ Res 2021; 197: 111097. https://doi.org/10.1016/j.envres.2021.111097.
6. Signorelli C, Odone A, Gianfredi V, et al. The spread of COVID-19 in six western metropolitan regions: a false myth on the excess of mortality in Lombardy and the defense of the city of Milan. Acta Biomed 2020; 91 (2): 23-30. https://doi.org/10.23750/abm.v91i2.9600.
7. Vinceti M, Filippini T, Rothman KJ, et al. Lockdown timing and efficacy in controlling COVID-19 using mobile phone tracking. EClinicalMedicine 2020; 25: 100457. https://doi.org/10.1016/j.eclinm.2020.100457.
8. Calina D, Hartung T, Mardare I, et al. COVID-19 pandemic and alcohol consumption: Impacts and interconnections. Toxicol Rep 2021; 8: 529-35. https://doi.org/10.1016/j.toxrep.2021.03.005.
9. Copat C, Cristaldi A, Fiore M, et al. The role of air pollution (PM and NO2) in COVID-19 spread and lethality: A systematic review. Environ Res 2020; 191: 110129. https://doi.org/10.1016/j.envres.2020.110129.
10. Dettori M, Deiana G, Balletto G, et al. Air pollutants and risk of death due to COVID-19 in Italy. Environ Res 2021; 192: 110459. https://doi.org/10.1016/j.envres.2020.110459.
11. Di Castelnuovo A, Bonaccio M, Costanzo S, et al. Common cardiovascular risk factors and in-hospital mortality in 3,894 patients with COVID-19: survival analysis and machine learning-based findings from the multicentre Italian CORIST Study. Nutr Metab Cardiovasc Dis 2020; 30 (11): 1899-913. https://doi.org/10.1016/j.numecd.2020.07.031.
12. Filippini T, Rothman KJ, Cocchio S, et al. Associations between mortality from COVID-19 in two Italian regions and outdoor air pollution as assessed through tropospheric nitrogen dioxide. Sci Total Environ 2021; 760: 143355. https://doi.org/10.1016/j.scitotenv.2020.143355.
13. Filippini T, Rothman KJ, Goffi A, et al. Satellite-detected tropospheric nitrogen dioxide and spread of SARS-CoV-2 infection in Northern Italy. Sci Total Environ 2020; 739: 140278. https://doi.org/10.1016/j.scitotenv.2020.140278.
14. Marques M, Domingo JL. Positive association between outdoor air pollution and the incidence and severity of COVID-19. A review of the recent scientific evidences. Environ Res 2021: 111930. https://doi.org/10.1016/j.envres.2021.111930.
15. Ovsyannikova IG, Haralambieva IH, Crooke SN, et al. The role of host genetics in the immune response to SARS-CoV-2 and COVID-19 susceptibility and severity. Immunol Rev 2020; 296 (1): 205-19. https://doi.org/10.1111/imr.12897.
16. ECDC. European Centre for Disease Prevention and Control Technical Report: Novel coronavirus (SARS-CoV-2). Discharge criteria for confirmed COVID-19 cases: When is it safe to discharge COVID-19 cases from the hospital or end home isolation? 2020. https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-Discharge-criteria.pdf. (Accessed September 7, 2021)
17. Lazzerini M, Sforzi I, Trapani S, et al. 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. Euro Surveill 2021; 26 (14): 2001248. https://doi.org/10.2807/1560-7917.ES.2021.26.14.2001248.
18. Di Castelnuovo A, Costanzo S, Antinori A, et al. Lopinavir/ritonavir and darunavir/cobicistat in hospitalized COVID-19 patients: Findings from the multicenter Italian CORIST study. Front Med (Lausanne) 2021; 8: 639970. https://doi.org/10.3389/fmed.2021.639970.
19. COVID-19 RISK and Treatments (CORIST) Collaboration. Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study. Eur J Intern Med 2020; 82: 38-47. https://doi.org/10.1016/j.ejim.2020.08.019.
20. Tsatsakis A, Calina D, Falzone L, et al. SARS-CoV-2 pathophysiology and its clinical implications: An integrative overview of the pharmacotherapeutic management of COVID-19. Food Chem Toxicol 2020; 146: 111769. https://doi.org/10.1016/j.fct.2020.111769.
21. Izzotti A, Fracchia E, Au W, et al. Prevention of COVID-19 infection and related complications by ozonized oils. J Pers Med 2021; 11 (3). https://doi.org/10.3390/jpm11030226.
22. Maestre-Muniz MM, Arias A, Mata-Vazquez E, et al. Long-term outcomes of patients with coronavirus disease 2019 at one year after hospital discharge. J Clin Med 2021; 10 (13): 2945. https://doi.org/10.3390/jcm10132945.
23. Salamanna F, Veronesi F, Martini L, et al. Post-COVID-19 syndrome: The persistent symptoms at the post-viral stage of the disease. A systematic review of the current data. Front Med (Lausanne) 2021; 8: 653516. https://doi.org/10.3389/fmed.2021.653516.
24. Calina D, Hernández AF, Hartung T, et al. Challenges and scientific prospects of the newest generation of mRNA-based vaccines against SARS-CoV-2. Life 2021; 11 (9): 907. https://doi.org/10.3390/life11090907.
25. Abu-Raddad LJ, Chemaitelly H, Coyle P, et al. SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy. EClinicalMedicine 2021; 35: 100861. https://doi.org/10.1016/j.eclinm.2021.100861.
26. Callaway E. Could new COVID variants undermine vaccines? Labs scramble to find out. Nature 2021; 589 (7841): 177-8. https://doi.org/10.1038/d41586-021-00031-0.
27. Giorgi Rossi P, Marino M, Formisano D, et al. Characteristics and outcomes of a cohort of COVID-19 patients in the Province of Reggio Emilia, Italy. PLoS One 2020; 15 (8): e0238281. https://doi.org/10.1371/journal.pone.0238281.
28. Choi SH, Kim HW, Kang JM, et al. Epidemiology and clinical features of coronavirus disease 2019 in children. Clin Exp Pediatr 2020; 63 (4): 125-32. https://doi.org/10.3345/cep.2020.00535.
29. Parri N, Magista AM, Marchetti F, et al. Characteristic of COVID-19 infection in pediatric patients: Early findings from two Italian Pediatric Research Networks. Eur J Pediatr 2020; 179 (8): 1315-23. https://doi.org/10.1007/s00431-020-03683-8.
30. Gudbjartsson DF, Helgason A, Jonsson H, et al. Spread of SARS-CoV-2 in the Icelandic population. N Engl J Med 2020; 382 (24): 2302-15. https://doi.org/10.1056/NEJMoa2006100.
31. Bailey LC, Razzaghi H, Burrows EK, et al. Assessment of 135794 pediatric patients tested for severe acute respiratory syndrome coronavirus 2 across the United States. JAMA Pediatr 2021; 175 (2): 176-84. https://doi.org/10.1001/jamapediatrics.2020.5052.
32. Ladhani SN, Amin-Chowdhury Z, Davies HG, et al. COVID-19 in children: Analysis of the first pandemic peak in England. Arch Dis Child 2020; 105 (12): 1180-5. https://doi.org/10.1136/archdischild-2020-320042.
33. Gotzinger F, Santiago-Garcia B, Noguera-Julian A, et al. COVID-19 in children and adolescents in Europe: A multinational, multicentre cohort study. Lancet Child Adolesc Health 2020; 4 (9): 653-61. https://doi.org/10.1016/S2352-4642(20)30177-2.
34. Hoang A, Chorath K, Moreira A, et al. COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine 2020; 24: 100433. https://doi.org/10.1016/j.eclinm.2020.100433.
35. Liguoro I, Pilotto C, Bonanni M, et al. SARS-COV-2 infection in children and newborns: A systematic review. Eur J Pediatr 2020; 179 (7): 1029-46. https://doi.org/10.1007/s00431-020-03684-7.
36. Bellino S, Rota MC, Riccardo F, et al. Pediatric COVID-19 cases prelockdown and postlockdown in Italy. Pediatrics 2021; 147 (2): e2020035238. https://doi.org/10.1542/peds.2020-035238.
37. West R, Michie S, Rubin GJ, et al. Applying principles of behaviour change to reduce SARS-CoV-2 transmission. Nat Hum Behav 2020; 4 (5): 451-9. https://doi.org/10.1038/s41562-020-0887-9.
38. DPCM 8 marzo 2020. https://www.gazzettaufficiale.it/eli/id/2020/03/08/20A01522/sg (Accessed September 7, 2021)
39. Paduano S, Marchesi I, Frezza G, et al. COVID-19 in school settings: Webinar aimed at both teachers and educators. Ann Ig 2021; 33 (6): 527-32. https://doi.org/10.7416/ai.2021.2437.
40. Signorelli C, Odone A, Stirparo G, et al. SARS-CoV-2 transmission in the Lombardy Region: the increase of household contagion and its implication for containment measures. Acta Biomed 2020; 91 (4): e2020195. https://doi.org/10.23750/abm.v91i4.10994.
41. Neagu M, Calina D, Docea AO, et al. Back to basics in COVID-19: Antigens and antibodies-Completing the puzzle. J Cell Mol Med 2021; 25 (10): 4523-33. https://doi.org/10.1111/jcmm.16462.
42. ECDC. European Centre for Disease Prevention and Control. Guidance for discharge and ending isolation in the context of widespread community transmission of COVID-19 – first update. 2020. https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-guidance-discharge-and-ending-isolation-first%20update.pdf. (Accessed September 7, 2021)
43. ISS. Special on COVID-19. Everything you need to know. 2020. https://www.iss.it/web/iss-en/at-home-isolation-quarantine-and-close-contacts. (Accessed September 7, 2021)
44. WHO. Laboratory testing strategy recommendations for COVID-19: Interim guidance, 21 March 2020. https://apps.who.int/iris/handle/10665/331509 (Accessed September 7, 2021)
45. Modena Statistics. On-line demographic data - Resident population and demographic flows2021. http://www.modenastatistiche.it. (Accessed September 7, 2021)
46. Farsalinos K, Poulas K, Kouretas D, et al. Improved strategies to counter the COVID-19 pandemic: Lockdowns vs. primary and community healthcare. Toxicol Rep 2021; 8: 1-9. https://doi.org/10.1016/j.toxrep.2020.12.001.
47. Odone A, Lugo A, Amerio A, et al. COVID-19 lockdown impact on lifestyle habits of Italian adults. Acta Biomed 2020; 91 (9-S): 87-9. https://doi.org/10.23750/abm.v91i9-S.10122.
48. Berselli N, Filippini T, Paduano S, et al. Seroprevalence of anti-SARS-CoV-2 antibodies in the Northern Italy population before the COVID-19 second wave. Int J Occup Med Environ Health 2022; 35 (1). https://doi.org/10.13075/ijomeh.1896.01826.
49. Esposito S, Marchetti F, Lanari M, et al. COVID-19 management in the pediatric age: Consensus document of the COVID-19 Working Group in Paediatrics of the Emilia-Romagna Region (RE-CO-Ped), Italy. Int J Environ Res Public Health 2021; 18 (8): 3919. https://doi.org/10.3390/ijerph18083919.
50. Ludvigsson JF. Children are unlikely to be the main drivers of the COVID-19 pandemic - A systematic review. Acta Paediatr 2020; 109 (8): 1525-30. https://doi.org/10.1111/apa.15371.
51. Viner RM, Mytton OT, Bonell C, et al. Susceptibility to SARS-CoV-2 infection among children and adolescents compared with adults: A systematic review and meta-analysis. JAMA Pediatr 2021; 175 (2): 143-56. https://doi.org/10.1001/jamapediatrics.2020.4573.
52. Larosa E, Djuric O, Cassinadri M, et al. Secondary transmission of COVID-19 in preschool and school settings in northern Italy after their reopening in September 2020: A population-based study. Euro Surveill 2020; 25 (49): 2001911. https://doi.org/10.2807/1560-7917.ES.2020.25.49.2001911.
53. Nunziata F, Poeta M, Vassallo E, et al. No spread of SARS-CoV-2 from infected symptomatic children to parents: A prospective cohort study in a controlled hospital setting. Front Pediatr 2021; 9: 720084. https://doi.org/10.3389/fped.2021.720084.
54. Forbes H, Morton CE, Bacon S, et al. Association between living with children and outcomes from COVID-19: OpenSAFELY cohort study of 12 million adults in England. BMJ 2021; 372: n628. https://doi.org/10.1136/bmj.n628.
55. Parri N, Lenge M, Buonsenso D, et al. Children with COVID-19 in Pediatric Emergency Departments in Italy. N Engl J Med 2020; 383 (2): 187-90. https://doi.org/10.1056/NEJMc2007617.
56. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020; 145 (6): e20200702. https://doi.org/10.1542/peds.2020-0702.
57. Lavezzo E, Franchin E, Ciavarella C, et al. Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'. Nature 2020; 584 (7821): 425-9. https://doi.org/10.1038/s41586-020-2488-1.
58. Modenese A, Mazzoli T, Berselli N, et al. Frequency of anti-SARS-CoV-2 antibodies in various occupational sectors in an industrialized area of Northern Italy from May to October 2020. Int J Environ Res Public Health 2021; 18 (15): 7948. https://doi.org/10.3390/ijerph18157948.
59. Reno C, Lenzi J, Golinelli D, et al. SARS-CoV-2/COVID-19 Testing: The Tower of Babel. Acta Biomed 2020; 91 (4): e2020144. https://doi.org/10.23750/abm.v91i4.10911.
60. Signorelli C, Fara GM. COVID-19: Hygiene and Public Health to the front. Acta Biomed 2020; 91 (3-S): 7-8. https://doi.org/10.23750/abm.v91i3-S.9507.
61. Hobbs CV, Martin LM, Kim SS, et al. Factors associated with positive SARS-CoV-2 test results in outpatient health facilities and emergency departments among children and adolescents aged <18 Years - Mississippi, September-November 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (50): 1925-9. https://doi.org/10.15585/mmwr.mm6950e3.