Providing pediatric well-care and sick visits in the COVID-19 pandemic era: the recommendations of the Italian pediatric
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(2020) 46:133
COMMENTARY
Open Access
Providing pediatric well-care and sick visits in the COVID-19 pandemic era: the recommendations of the Italian pediatric society Rino Agostiniani, Elena Bozzola* , Annamaria Staiano, Antonio Del Vecchio, Teresa Mazzone, Luigi Greco, Giovanni Corsello and Alberto Villani
Abstract Pediatricians have observed a significant decrease in in-person child health visits during the COVID-19 pandemic. In the post lockdown period, the coronavirus trend remains positive in Italy but fears of a second wave have recently grown in Italy due to active hotbeds of contagion. The pandemic may negatively affect the care of pediatric patients and overall children welfare as it may present with severe signs and symptoms or it may complicate. The Italian Pediatric Society recommend to separate well visits from sick ones, to educate families and to promote hygienic strategies to provide an adequate pediatric assistance in case of a second pandemic wave. Keywords: Children, COVID19, Visit
Background Pediatric patients with coronavirus disease 2019 (COVID-19) may experience flu-like signs or symptoms over the course of the disease, such as fever, cough, nasal congestion or rhinorrhea, sore throat, diarrhea, nausea or vomiting [1, 2]. In children illness severity may range from an asymptomatic to a critical condition. Clinical presentation may be as follow [1]:
asymptomatic mild (including fever, fatigue, myalgia, cough) moderate (such as pneumonia) severe (such as dyspnea, hypoxia) critical (such as acute respiratory distress syndrome, respiratory failure, shock, or multi-organ dysfunction).
* Correspondence: [email protected] The Italian Pediatric Society, Rome, Italy
In Italy, the pediatric cases are actually 2100 in children aged 0–9 years and 3745 in those aged 10–19 years, respectively 0,9% and 1,6% of the total cases [3]. Fewer cases of COVID-19 among children compared to adult cases are reported, partially due to under diagnosis [4]. In fact, most pediatric cases are asymptomatic or with mild-moderate symptoms [5]. Nevertheless, pediatric cases of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been reported, as well as rare hyperinflammatory states (Kawasaki-like syndrome). Due to the recent onset of COVID-19 pandemic disease, long term consequences are inevitably unknown at present. Data suggest that toddler younger than 12 months as well as underlying medical conditions represent severity risk factors [5]. Age-stratified analysis showed that the SARS in children was 4.7% compared with 17.1% in adults and that the odds of infection in children was 0.26 times (95%CI 0.13–0.54) of that among the elderly [6, 7]. Although most pediatric cases are mild, pediatricians should
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the origin
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