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Tytuł:
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COVID-19 in 17 Italian Pediatric Emergency Departments.
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Autorzy:
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Parri, Niccolò
Lenge, Matteo
Cantoni, Barbara
Arrighini, Alberto
Romanengo, Marta
Urbino, Antonio
Da Dalt, Liviana
Verdoni, Lucio
Giacchero, Roberta
Lanari, Marcello
Musolino, Anna Maria
Biban, Paolo
La Fauci, Giovanna
Pilotto, Chiara
Buonsenso, Danilo
Chiossi, Massimo
Agostiniani, Rino
Plebani, Anna
Zampogna, Stefania
Barbieri, Maria Antonietta
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Temat:
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CHEST X rays
INFECTIOUS disease transmission
COMPUTED tomography
HOSPITAL emergency services
LONGITUDINAL method
LUNGS
MEDICAL records
PEDIATRICS
RETROSPECTIVE studies
DESCRIPTIVE statistics
ACQUISITION of data methodology
COVID-19
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Źródło:
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Pediatrics. Dec2020, Vol. 146 Issue 6, p1-11. 11p.
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Terminy geograficzne:
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ITALY
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BACKGROUND: Variability in presentation of children with coronavirus disease 2019 (COVID-19) is a challenge in emergency departments (EDs) in terms of early recognition, which has an effect on disease control and prevention. We describe a cohort of 170 children with COVID-19 and differences with the published cohorts. METHODS: Retrospective chart reviews on children (0-18 years) evaluated in 17 Italian pediatric EDs. RESULTS: In our cohort (median age of 45 months; interquartile range of 4 months-10.7 years), we found a high number of patients,1 year with COVID-19 disease. The exposure happened mainly (59%) outside family clusters; 22% had comorbidities. Children were more frequently asymptomatic (17%) or with mild diseases (63%). Common symptoms were cough (43%) and difficulty feeding (35%). Chest computed tomography, chest radiograph, and point-of-care lung ultrasound were used in 2%, 36%, and 8% of cases, respectively. Forty-three percent of patients were admitted because of their clinical conditions. The minimal use of computed tomography and chest radiograph may have led to a reduced identification of moderate cases, which may have been clinically classified as mild cases. CONCLUSIONS: Italian children evaluated in the ED infrequently have notable disease symptoms. For pediatrics, COVID-19 may have rare but serious and life-threatening presentations but, in the majority of cases, represents an organizational burden for the ED. These data should not lower the attention to and preparedness for COVID-19 disease because children may represent a source of viral transmission. A clinically driven classification, instead of a radiologic, could be more valuable in predicting patient needs and better allocating resources. [ABSTRACT FROM AUTHOR]
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