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1. Epidemiology, Clinical Features and Prognostic Factors of Pediatric SARS-CoV-2 Infection: Results From an Italian Multicenter Study

Author

Silvia Garazzino, Andrea Lo Vecchio, Luca Pierantoni, Francesca Ippolita Calò Carducci, Federico Marchetti, Antonella Meini, Elio Castagnola, Gianluca Vergine, Daniele Donà, Samantha Bosis, Icilio Dodi, Elisabetta Venturini, Enrico Felici, Roberta Giacchero, Marco Denina, Luca Pierri, Giangiacomo Nicolini, Carlotta Montagnani, Andrzej Krzysztofiak, Sonia Bianchini, Caterina Marabotto, Pier-Angelo Tovo, Giulia Pruccoli, Marcello Lanari, Alberto Villani, Guido Castelli Gattinara, The Italian SITIP-SIP Pediatric Infection Study Group, Valeria Caldarelli, Filippo Maria Salvini, Giovanni Corsello, Barba Paolo Del, Paola Berlese, Carlo Agostoni, Chiara Ghizzi, Vera Quadri, Sara Riscassi, Ivana Rabbone, Carmelina Calitri, Luisa Abbagnato, Luciana Parola, Giuseppe Banderali, Ilaria Pacati, Simonetta Cherubini, Paola Lippi, Andrea Guala, Rino Agostiniani, Salvatore Cazzato, Ahmad Kantar, Luca Baroero, Nadia Rossi, Cristina Dalmazzo, Laura Panigati, Paolo Manzoni, Alessandro Vigo, Ludovica Fiore, Pasquale Comberiati, Gianna Battezzati, Paola Verna, Gianluca Tornese, Paola Gianino, Luca Bertacca, Angelina Vaccaro, Giorgio Zavarise, Luigi Marchione, Paola Gallia, Paola Di Filippo, Chiara Centenari, Alessandra Iacono, Alessandro Plebani, Marta Ferretti, Sara Rizzi, Sara Rossin, Paola Marchisio, Alessandro De Fanti, Costantino De Giacomo, Giuliana Ferrante, Graziano Barera, Pajno Roberta, Stefano Martelossi, Alessia Rocchi, Rosa Francavilla, Valin Paola Sogno, Marco Poeta, Piero Valentini, Raffaele Papa, Anna Maria Magistà, Raffaele Badolato, Carolina Saffioti, Maria Cristina Greco, Paola Costenaro, Maria Di Pietro, Susanna Esposito, Giovanni Pieri, Maria Valentina Spartà, Valentina Maffini, Laura Cursi, Francesco Nunziata, Federica Mignone, Claudia Bondone, Giacomo Stera, Agostina Marolda, Lorenzo Fiorica, Caterina Sabatini, Maria Rita Genovese, Cristina Ferrari, and Luisa Galli

Subjects
SARS-CoV-2 infection, children, multisystem inflammatory syndrome, MIS-C, COVID-19, Pediatrics, RJ1-570
Abstract

Background: Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear and optimal treatment is debated. The objective of our study was to investigate epidemiological, clinical and therapeutic characteristics of pediatric SARS-CoV-2 infection, focusing on risk factors for complicated and critical disease.Methods: The present multicenter Italian study was promoted by the Italian Society of Pediatric Infectious Diseases, involving both pediatric hospitals and general pediatricians/family doctors. All subjects under 18 years of age with documented SARS-CoV-2 infection and referred to the coordinating center were enrolled from March 2020.Results: As of 15 September 2020, 759 children were enrolled (median age 7.2 years, IQR 1.4; 12.4). Among the 688 symptomatic children, fever was the most common symptom (81.9%). Barely 47% of children were hospitalized for COVID-19. Age was inversely related to hospital admission (p < 0.01) and linearly to length of stay (p = 0.014). One hundred forty-nine children (19.6%) developed complications. Comorbidities were risk factors for complications (p < 0.001). Viral coinfections, underlying clinical conditions, age 5–9 years and lymphopenia were statistically related to ICU admission (p < 0.05).Conclusions: Complications of COVID-19 in children are related to comorbidities and increase with age. Viral co-infections are additional risk factors for disease progression and multisystem inflammatory syndrome temporarily related to COVID-19 (MIS-C) for ICU admission.

Published
2021
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2. Automatic feedback generation in scenario-based e-learning with an application to the healthcare sector

Author

Paola Beltrami, Pierluigi Crescenzi, Giacomo Gensini, Alessandro Innocenti, Paola Lippi, and Nicoletta Saccone

Subjects
Theory and practice of education, LB5-3640
Abstract

The aim of this paper is to propose a scenario-based course model inspired by the «game-book» paradigm in which the learner has the opportunity to choose his/her own adventure. In particular, our aim is to develop a model that provides a mechanism for automatically generating semantically rich feedback to the learner during and at the end of the learning process. To this aim, the system individualizes and analyzes the learner’s personal learning paths, so that immediate feedback is given according to the choices taken. The feedback algorithm gives indications to the learner about the points in which a presumably incorrect behaviour has been followed. In particular, feedback is provided through an «indicator of quality» which is based on the topology of the graph induced by the scenario-based environment. We applied our model to the healthcare sector, which is experiencing a phase of considerable growth. In particular, we considered the problem of the waiting lists in Radiology. The course is composed of several scenarios that describe the situation at the current time, the resources available and the performable choices (examples of resources available are the number of surgeons and the quantity of available fi nancial resources, while the choices are mainly related to the number and the level of instruction of surgeons and to the status of the technology). The course implementation is basically complete and a preliminary experimentation will be executed in the near future.

Published
2012
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3. Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Author

Garazzino, S., Montagnani, C., Dona, D., Meini, A., Felici, E., Vergine, G., Bernardi, S., Giacchero, R., Vecchio, A. L., Marchisio, P., Nicolini, G., Pierantoni, L., Rabbone, I., Banderali, G., Denina, M., Venturini, E., Krzysztofiak, A., Badolato, R., Bianchini, S., Galli, L., Villani, A., Castelli-Gattinara, G., Salvini, F., Abbagnato, L., Castagnola, E., Dodi, I., Ghitti, C., Lippi, P., Agostiniani, R., Cherubini, S., Valentini, P., Gianino, P., Vaccaro, A., Manzoni, P., Verna, P., Comberiati, P., Di Filippo, P., Gallia, P., Battezzati, G., Fiore, L., Dalmazzo, C., Tappi, E., Lazzerini, M., Tovo, P. -A., Scolfaro, C., Pruccoli, G., Ramenghi, U., Giaquinto, C., da Dalt, L., Tornese, G., Berlese, P., Plebani, A., Manno, E. C., Santilli, V., Lancella, L., Cursi, L., Campana, A., Bozzola, E., Bosis, S., Lanari, M., Pecoraro, C., Del Barba, P., Nicastro, E., Esposito, S., Zuccotti, G. V., Corsello, G., Cardinale, F., Tocco, A. M., Ballardini, G., Agostoni, C., Chiappini, E., Indolfi, G., Anna, B., Cazzato, S., Zavarise, G., Pignata, C., Marchetti, F., Garazzino S., Montagnani C., Dona D., Meini A., Felici E., Vergine G., Bernardi S., Giacchero R., Vecchio A.L., Marchisio P., Nicolini G., Pierantoni L., Rabbone I., Banderali G., Denina M., Venturini E., Krzysztofiak A., Badolato R., Bianchini S., Galli L., Villani A., Castelli-Gattinara G., Salvini F., Abbagnato L., Castagnola E., Dodi I., Ghitti C., Lippi P., Agostiniani R., Cherubini S., Valentini P., Gianino P., Vaccaro A., Manzoni P., Verna P., Comberiati P., Di Filippo P., Gallia P., Battezzati G., Fiore L., Dalmazzo C., Tappi E., Lazzerini M., Tovo P.-A., Scolfaro C., Pruccoli G., Ramenghi U., Giaquinto C., da Dalt L., Tornese G., Berlese P., Plebani A., Manno E.C., Santilli V., Lancella L., Cursi L., Campana A., Bozzola E., Bosis S., Lanari M., Pecoraro C., Del Barba P., Nicastro E., Esposito S., Zuccotti G.V., Corsello G., Cardinale F., Tocco A.M., Ballardini G., Agostoni C., Chiappini E., Indolfi G., Anna B., Cazzato S., Zavarise G., Pignata C., Marchetti F., Garazzino, S., Montagnani, C., Dona, D., Meini, A., Felici, E., Vergine, G., Bernardi, S., Giacchero, R., Vecchio, A. L., Marchisio, P., Nicolini, G., Pierantoni, L., Rabbone, I., Banderali, G., Denina, M., Venturini, E., Krzysztofiak, A., Badolato, R., Bianchini, S., Galli, L., Villani, A., Castelli-Gattinara, G, Tornese, G, Filippo Salvini, Laura Abbagnato, Elio Castagnola, Icilio Dodi, Cesare Ghitti, Paola Lippi, Rino Agostiniani, Simonetta Cherubini, Piero Valentini, Paola Gianino, Angelina Vaccaro, Paolo Manzoni, Paola Verna, Pasquale Comberiati, Paola Di Filippo, Paola Gallia, Gianna Battezzati, Ludovica Fiore, Cristina Dalmazzo, Eleonora Tappi, Marta Lazzerini, PierAngelo Tovo, Carlo Scolfaro, Giulia Pruccoli, Ugo Ramenghi, Carlo Giaquinto, Liviana Da Dalt, Gianluca Tornese, Paola Berlese, Alessandro Plebani, Emma Concetta Manno, Veronica Santilli, Laura Lancella, Laura Cursi, Andrea Campana, Elena Bozzola, Samantha Bosis, Marcello Lanari, Carmine Pecoraro, Paolo Del Barba, Emanuele Nicastro, Silvia Garazzino, Carlotta Montagnani, Daniele Donà, Antonella Meini, Enrico Felici, Gianluca Vergine, Stefania Bernardi, Roberta Giacchero, Andrea Lo Vecchio, Paola Marchisio, Giangiacomo Nicolini, Luca Pierantoni, Ivana Rabbone, Giuseppe Banderali, Marco Denina, Elisabetta Venturini, Andrzej Krzysztofiak , Raffaele Badolato, Sonia Bianchini, Luisa Galli, Alberto Villani , Guido Castelli-Gattinara, Susanna Esposito, Gian Vincenzo Zuccotti, Giovanni Corsello, Fabio Cardinale, Anna Maria Tocco, Giuseppina Ballardini, Carlo Agostoni, Elena Chiappini, Giuseppe Indolfi, Bussolini Anna, Salvatore Cazzato, Giorgio Zavarise, Claudio Pignata, Federico Marchetti, Lo Vecchio, A., and Castelli-Gattinara, G.

Subjects
Male, Pediatrics, Epidemiology, Protease Inhibitor, Comorbidity, medicine.disease_cause, Clinical Laboratory Technique, Severe Acute Respiratory Syndrome, Disease Outbreaks, Feces, 0302 clinical medicine, Settore MED/38 - Pediatria Generale E Specialistica, COVID-19 Testing, Retrospective Studie, Pandemic, 030212 general & internal medicine, Viral, Child, Coronavirus, Pediatric, Disease Outbreak, Coinfection, Hospitals, Pediatric, Settore MED/38, Hospitals, Diarrhea, Treatment Outcome, SARS-CoV-2 infection, children, covid-19, hydroxychloroquine, pneumonia, Adolescent, Antiviral Agents, Betacoronavirus, COVID-19, Child, Preschool, Chronic Disease, Clinical Laboratory Techniques, Coronavirus Infections, Female, Fever, Humans, Immunocompromised Host, Infant, Infant, Newborn, Italy, Noninvasive Ventilation, Pandemics, Pneumonia, Viral, Protease Inhibitors, Retrospective Studies, SARS-CoV-2, medicine.symptom, Rapid Communication, Human, medicine.medical_specialty, Coronaviru, 03 medical and health sciences, 030225 pediatrics, Virology, Intensive care, medicine, Preschool, Antiviral Agent, Betacoronaviru, business.industry, Coronavirus Infection, Public Health, Environmental and Occupational Health, Retrospective cohort study, medicine.disease, Newborn, Pneumonia, Fece, business
Abstract

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day–17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered.

Published
2020

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