Skip to main content

Year 2022: exploring COVID-19 pandemic in children

Abstract

COVID-19 pandemics is rapidly changing. In this article, we review progresses published in the Italian Journal of Pediatrics in 2022. More data on clinical pictures, prevention strategies and active management in children have been provided. The continued evolution of knowledge has driven transformations in the clinical approach to the disease and allowed key advancements in the care of children with COVID-19.

Introduction

Since its first description in December 2019, COVID-19 pandemic continued to spread across the globe, increasing our knowledge on Sars-Cov2 and on its consequence on human health. In particular, the initial impression that minors might be rarely infected by the virus was replaced by a more nuanced understanding of infectious manifestations in children across Countries and by the recognition of disease presentation.

Aim of the review is to explore the state of knowledge on COVID-19 in children on the base of published literature in the Italian Journal of Pediatrics during 2022 year.

Material and methods

For the purpose of the study, reports published in Italian Journal of Pediatrics from January 2022 till December 2022 and concerning COVID 19 pandemics have been examined. Identified key words to perform the research process were: SARS-CoV-2; COVID-19; children; prevention; diagnosis; transmission; treatment; health care facilities; behaviour.

Researchers focused their studies on understanding clinical findings as well as in discussing influence on other diseases, preventive strategies and therapeutical approach.

Results

According to the search strategy, 29 articles have been included in the revision.

Evidence confirmed that in children the acute clinical presentation is generally milder than in adults. Children infected by SARS-CoV-2 even when symptomatic generally clear the virus and recover within a few days [1]. Symptoms may vary depending on age and on virus’ variants, generally including fever, rhinorrea, cough, vomiting, diarrhoea and sore throat. Several cutaneous manifestations related to COVID-19 infection have been already observed, including perniosis-like or chilblain-like lesions, characterized by vascular lesions due to microthrombosis and endothelial inflammation [2,3,4]. Unusual presentation have been described in case reports, including paralysis of the facial nerve in the acute phase or a few weeks after as well as abducens nerve palsy [5,6,7]. As for laboratory findings, most children with COVID-19 has a normal white blood count; lymphopenia is rare while neutropenia seems to be one of the altered parameters recorded more in paediatric cases than in adults [8,9,10].

Even if children were asymptomatic or affected by mild symptoms, they may as well experience long term sequelae as well as adult [11,12,13]. In details, two sequelae of paediatric COVID-19 have been identified: the multisystem inflammatory syndrome in children (MIS-C) and the long COVID [13]. MIS-C is a rare but severe hyperinflammatory disease that affects paediatric patients, typically 3–6 weeks after SARS-CoV2 contact. Most patients are previously healthy children, without relevant comorbidities [14] cardiovascular system represents the most common target organ in patients with MIS-C with electrocardiographic abnormalities and increased cardiac laboratory indices, including troponin T and NT, pro BNP levels and the risk of compromised heart function [15,16,17]. The cardiac involvement may be so severe to require intensive care unit, long hospitalization, and an aggressive therapy [18].

The Italian Intersociety Consensus recommends to look for symptoms suggestive of long COVID near the end of the acute phase of the disease as well as 4–12 weeks from this [13]. Long-Covid 19 may develop regardless the acute disease course and the gender even if being symptomatic during the SARS-CoV-2 infection increased six folds the risk of having at least one symptom of long COVID-19, [12, 19, 20]. Evidence suggests that long COVID have specific clinical characteristics [21, 22]. Symptoms suggestive for Long COVID in children and adolescents include persistent headache and fatigue, sleep disturbance, difficulty in concentrating, abdominal pain, myalgia or arthralgia. According to the Consensus, possible symptoms of long COVID include persistent chest pain, stomach pain, diarrhoea, heart palpitations, and skin lesions [13]. Older age and high body max index correlate to an increased risk for persistent symptoms after SARS-CoV-2 infection in children [11, 20, 23]. Children 0–5 years old had a higher risk of respiratory symptoms, while adolescents of neuro-psychological Long COVID-19 symptoms [12].

Apart from physical impairment, mental problems should be kept in mind. Bloise et al. reported that almost half of infected children presented with psychological symptoms and one out of five long-term sequelae [11]. As Gatta and al noted, there was a great increase in eating disorders, suicidal and self-harming attempts [24].

According to these findings, after COVID 19 onset, despite a great decline of paediatric emergency department admissions, there was a significant increase in patient access for neuropsychiatric diseases, in particular suicidal ideation, depression, eating disorder and psychosis. An increase in hospitalization was observed as well, mainly referring suicidal ideation, depression, eating disorder and drug abuse [25,26,27]. Moreover, throughout the period of infection, children spent most of the time on devices like tv-video, social media and mobile phone for non-educational activities [11]. Evidence suggest that minors look for pro-Ana materials on TikTok, Twitter or on other social media platforms [28]. Images or videos may also lead users to emulate related behaviours with an increased risk of eating disorders, suicidal or self-injury [29,30,31]. So, it is important to investigate the impact of the infection on children’s mental health even in absence of physical impairment and to promote nutritional and psychological support [32, 33].

With regard to self-injuring, suicidal behaviour more likely occurred during the second wave of the COVID-19 pandemic [26, 34]. In line, pharmacological therapies prescription increased to more than 80% of inpatients during the COVID year, mainly neuroleptics [24].

Influence on other diseases

Of note, COVID-19 pandemic had also an indirect effect on other diseases, interfering with their epidemiology and diagnostic approach. For example, a strong impact on the diagnosis and management of diabetes in children was noted, revealing a more severe onset presentation compared to pre-pandemic period [35,36,37]. A significant reduction of stimulating tests investigating growth hormone secretion in short children have been described in a paediatric endocrinology outpatient department. Although these children might have undergone the exam and eventually treated at a later stage, it is known that the efficacy of treatment is higher when the diagnosis is prompt. In case of a delay in the diagnosis and therapy, the risk of an adult short stature is high [38]. Opposite, evidence suggests that there was an increment of precocious puberty during the pandemic period compared to previous period [38,39,40,41,42]. Additionally, central precocious puberty had been found linked to sleep disturbances even if the relationship has been not fully explained [39]. As evidenced by Mutlu et al., girls referred for early puberty during COVID-19 pandemic were younger than in the previous period. Of note real precocious puberty was more prevalent than pubertal variants, so that the need for pubertal suppression therapy had increased as expected [43].

Again, Mameli et al. demonstrated that COVID-19 pandemic altered the epidemiology of acute respiratory tract infections in children aged 0–5 years, with toddlers younger than 12 months of age at a higher risk [44]. Hygiene measures, social distancing, and masks by the older children may have influenced the results as well [45, 46]. Finally, Covid-19 pandemic had also an impact on reproductive health, perinatal period, and childbirth. In Iran, the incidence of congenital birth anomalies had been found significantly increased during pandemic period, mainly referring to congenital anomalies of the central nervous and genitourinary systems [47,48,49]. Many factors might have contribute to congenital abnormalities, including chronic maternal stress, decreased routine access to prenatal care for foetal screening and diagnosis and poverty [47].

Prevention and therapy

Children with some specific chronic diseases are considered at risk of a severe disease course. The Italian Society of Pediatrics together with affiliated Scientific Societies recently proposed a Consensus document to detail which patients affected by comorbidities may be benefit for monoclonal antibodies administration [50,51,52]. As for the others, it is not possible to identify which ones may develop severe clinical manifestations, long COVID or psychosocial problems [21, 53]. Allergic rhino conjunctivitis and asthma, if under control, do not represent risk factors for the susceptibility to SARS CoV2. (54i) Patients with allergies do not present a more severe course than those without in line with the hypothesis of a positive role exerted by the Th2 immune response in COVID-19 pathogenesis [54,55,56].

Researchers agree on the key role of vaccination to prevent Sars Cov2 infection and, most of all, severe disease. According to The manifesto of Pediatricians of Emilia-Romagna region vaccines against COVID are the most effective and safe tool to contrast COVID 19 and for this reason should be considered as a right of children to protect themselves [57]. Vaccine product-related reactions are seldom reported such as Henoch-Schoenlein purpura reported in an adolescent by Casini et al. [58]. Nonetheless, the benefits of vaccination greatly outweigh the risks [57, 59]. Moreover, the likelihood of severe reactions such as anaphylaxis to COVID-19 mRNA vaccines in children seems very low [60, 61]. In case of previous systemic reaction to COVID-19 vaccines or excipients, Scientific Societies suggest to limit contraindications to vaccination and help to safely immunize [62].

The vaccination availability together with the application of safety protocols gives the opportunity not only to prevent infection spread but also to schedule clinical controls as well as diagnostic procedures which may have been postponed in non-urgent cases, such as pulmonary function tests [63, 64].

Nevertheless, vaccination coverage in the pediatric age is actually lower compared to adults, leading minors to a higher susceptibility to SARS-CoV-2 [65]. Of notes, many parents have a positive attitude towards their children’s vaccination [66]. Factors that may influence children’s willingness to be vaccinated against COVID-19 include gender, age, residence, number of children in the household, parent education [67, 68]. Adolescents as well have been described in favour of immunisation by Cupertino et al. Parents' opinion strongly affects the immunization status of adolescents as in Cupertino et al. survey the most important predictors of being immunized against SARS-CoV2 were having both parents immunized. Of note, minors reported their willing on getting COVID 19 vaccine information by family doctors and at school, underling the potential role of paediatricians and school educators [69]. Increased information and sensibilization on the safety and efficacy of vaccination is required to increase vaccine coverage and should be supported by effective persuasion campaign for those reluctant to accept the vaccine [70].

Strength of our manuscript is to summarize the latest evidence on COVID 19 as published in the Italian Journal of Pediatrics, an open access peer-reviewed journal that includes all aspects of pediatric medicine. Limiting the search strategy to articles published in the Italian Journal of Pediatrics in 2022 represents the weakness of the present manuscript.

Conclusions

New insights in COVID-19 continue to be presented. This is reflected by many studies on COVID-19 that have been published by Italian Journal of Pediatrics during the past year. We expect that in the coming years ongoing trials will provide options for improving prevention and for allowing an effective treatment.

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Abbreviations

COVID-19:

Coronavirus disease of 2019

SARS-CoV-2:

Severe acute respiratory syndrome coronavirus

MIS-C:

Multisystem infammatory syndrome in children

References

  1. Howard-Jones AR, Burgner DP, Crawford NW, Goeman E, Gray PE, Hsu P, et al. COVID-19 in children. II: Pathogenesis, disease spectrum and management. J Paediatr Child Health. 2021; Epub Oct 25.

  2. Paparella R, Tarani L, Properzi E, Costantino F, Saburri C, Lucibello R, Richetta A, Spalice A, Leonardi L. Chilblain-like lesions onset during SARS-CoV-2 infection in a COVID-19-vaccinated adolescent: case report and review of literature. Ital J Pediatr. 2022;48(1):93.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Molaee H, Emadi SN, M’Imunya JMN, Davoudi-Monfared E, Mohammed A, Razavi Z. Chilblain or perniosis-like skin lesions in children during the COVID -19 pandemic: A systematic review of articles. Dermatol Ther. 2022;35(3):e15298.

    CAS  PubMed  Google Scholar 

  4. Naderi-Azad S, Vender R. Lessons From the first wave of the pandemic: skin features of COVID-19 Can Be Divided Into Inflammatory and Vascular Patterns. J Cutan Med Surg. 2021;25(2):169–76.

    CAS  PubMed  Google Scholar 

  5. Capponi M, Cinicola BL, Brindisi G, Guido CA, Torcé MC, Zicari AM, Spalice A. COVID-19 and abducens nerve palsy in a 9-year-old girl-case report. Ital J Pediatr. 2022;48(1):102.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Iacono A, Pennisi E, Benincasa C, Marchetti F. A case of facial nerve palsy in a pediatric patient associated with Covid-19. Ital J Pediatr. 2022;48(1):75.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Brisca G, Garbarino F, Carta S, Palmieri A, Vandone M, Severino M, et al. Increased childhood peripheral facial palsy in the emergency department during COVID-19 pandemic. Pediatr Emerg Care. 2020;36(10):e595–6.

    PubMed  Google Scholar 

  8. Dinkin M, Gao V, Kahan J, Bobker S, Simonetto M, Wechsler P, et al. COVID- 19 presenting with ophthalmoparesis from cranial nerve palsy. Neurology. 2020;95(5):221–3.

    CAS  PubMed  Google Scholar 

  9. Parri N, Lenge M, Buonsenso D. Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group. Children with Covid-19 in Pediatric Emergency Departments in Italy. N Engl J Med. 2020;383(2):187–90.

    CAS  PubMed  Google Scholar 

  10. Romani L, Chiurchiù S, Santilli V, Bernardi S, Haywood Lombardi M, Scarselli A, Villani A, CiofDegliAtti ML, Campana A, D’Argenio P. COVID19 in Italian paediatric patients: the experience of a tertiary children’s hospital. Acta Paediatr. 2020;109(11):2311–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Bloise S, Isoldi S, Marcellino A, De Luca E, Dilillo A, Mallardo S, Martucci V, Sanseviero M, Del Giudice E, Iorfida D, Leone R, Testa A, Frasacco B, Gizzone P, Proietti Ciolli C, Sinceri A, Zuliani F, Zanardi E, Gambarotto A, Lisa Grandinetti A, Ventriglia F, Lubrano R. Clinical picture and long-term symptoms of SARS-CoV-2 infection in an Italian pediatric population. Ital J Pediatr. 2022;48(1):79.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Trapani G, Verlato G, Bertino E, Maiocco G, Vesentini R, Spadavecchia A, Dessì A, Fanos V. Long COVID-19 in children: an Italian cohort study. Ital J Pediatr. 2022;48(1):83.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Esposito S, Principi N, Azzari C, Cardinale F, Di Mauro G, Galli L, Gattinara GC, Fainardi V, Guarino A, Lancella L, Licari A, Mancino E, Marseglia GL, Leonardi S, Nenna R, Zampogna S, Zona S, Staiano A, Midulla F. Italian intersociety consensus on management of long covid in children. Ital J Pediatr. 2022;48(1):42.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, et al. Acute heart failure in multisystem inflammatory syndrome in children in the context of global SARS-CoV-2 pandemic. Circulation. 2020;142(5):429–36.

    CAS  PubMed  Google Scholar 

  15. Regan W, O’Byrne L, Stewart K, Miller O, Pushparajah K, Theocharis P, et al. Electrocardiographic changes in children with multisystem inflammation associated with COVID-19: associated with coronavirus disease 2019. J Pediatr. 2021;234:27-32.e2.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. HaghighiAski B, ManafiAnari A, AbolhasanChoobdar F, ZarehMahmoudabadi R, Sakhaei M. Cardiac abnormalities due to multisystem inflammatory syndrome temporally associated with Covid-19 among children: a systematic review and meta-analysis. IJC Hear Vasc. 2021;33:100764.

    Google Scholar 

  17. Mannarino S, Raso I, Garbin M, Ghidoni E, Corti C, Goletto S, Nespoli L, Santacesaria S, Zoia E, Camporesi A, Izzo F, Dilillo D, Fiori L, D’Auria E, Silvestri A, Dolci A, Calcaterra V, Zuccotti G. Cardiac dysfunction in Multisystem inflammatory syndrome in children: an Italian single-center study. Ital J Pediatr. 2022;48(1):25.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Son MBF, Murray N, Friedman K, et al. Multisystem inflammatory syndrome in children — initial therapy and outcomes. N Engl J Med. 2021;385:23–34.

    CAS  PubMed  Google Scholar 

  19. Montani D, Savale L, Noel N, Meyrignac O, Colle R, Gasnier M, Corruble E, Beurnier A, Jutant EM, Pham T, Lecoq AL, Papon JF, Figueiredo S, Harrois A, Humbert M, Monnet X, COMEBAC Study Group. Post-acute COVID-19 syndrome. Eur Respir Rev. 2022;31(163):210185.

    PubMed  PubMed Central  Google Scholar 

  20. Osmanov IM, Spiridonova E, Bobkova P. Risk factors for Long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study. Eur Respir J. 2021;1:2101341.

    Google Scholar 

  21. Buonsenso D, Di Giuda D, Sigfrid L, Pizzuto DA, Di Sante G, De Rose C, et al. Evidence of lung perfusion defects and ongoing infammation in an adolescent with post-acute sequelae of SARS-CoV-2 infection. Lancet Child Adolesc Health. 2021;5:677–80.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Morand A, Campion JY, Lepine A, Bosdure E, Luciani L, Cammilleri S, et al. Similar patterns of [18F]-FDG brain PET hypometabolism in paediatric and adult patients with long COVID: a paediatric case series. Eur J Nucl Med Mol Imaging. 2021; Epub Aug 19:1–8.

  23. Monteiro R, Azevedo I. Chronic infammation in obesity and the metabolic syndrome. Mediators Infamm. 2010;2010:289645.

    Google Scholar 

  24. Gatta M, Raffagnato A, Mason F, Fasolato R, Traverso A, Zanato S. Miscioscia M Sociodemographic and clinical characteristics of paediatric patients admitted to a neuropsychiatric care hospital in the COVID-19 era. Ital J Pediatr. 2022;48(1):23.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Bozzola E, Ferrara P, Spina G, Villani A, Roversi M, Raponi M, Corsello G, Staiano A. The pandemic within the pandemic: the surge of neuropsychological disorders in. Italian children during the COVID-19 era Italian Pediatric COVID-19 Board. Ital J Pediatr. 2022;48(1):126.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Hill RM, Rufno K, Kurian S, Saxena J, Saxena K, Williams L. Suicide Ideation and Attempts in a Pediatric Emergency Department Before and During COVID-19. Pediatrics. 2021;147(3):e2020029280. https://doi.org/10.1542/peds.2020-029280.

    Article  PubMed  Google Scholar 

  27. Krauss P, Dalton E, Doupnik SK, et al. US pediatric emergency department visits for mental health conditions during the COVID-19 pandemic. JAMA Netw Open. 2021;4:e218533.

    Google Scholar 

  28. Pruccoli J, De Rosa M, Chiasso L, Perrone A. Parmeggiani A The use of TikTok among children and adolescents with Eating Disorders: experience in a third-level public Italian center during the SARS-CoV-2 pandemic. Ital J Pediatr. 2022;48(1):138.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Sukunesan S, Huynh M, Sharp G. Examining the Pro-Eating Disorders Community on Twitter Via the Hashtag #proana: Statistical Modeling Approach. JMIR Ment Health. 2021;8(7):e24340.

    PubMed  PubMed Central  Google Scholar 

  30. Logrieco G, Marchili MR, Roversi M, Villani A. The paradox of tik tok anti-pro-anorexia videos: how social media can promote non-suicidal self-injury and anorexia. Int J Environ Res Public Health. 2021;18(3):1041.

    PubMed  PubMed Central  Google Scholar 

  31. Manzar MD, Albougami A, Usman N, Mamun MA. Suicide among adolescents and youths during the COVID-19 pandemic lockdowns: A press media reports-based exploratory study. J Child Adolesc Psychiatr Nurs. 2021;34(2):139–46.

    PubMed  PubMed Central  Google Scholar 

  32. Scapaticci S, Neri CR, Marseglia GL, Staiano A, Chiarelli F, Verduci E. The impact of the COVID-19 pandemic on lifestyle behaviors in children and adolescents: an international overview. Ital J Pediatr. 2022;48(1):22.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. de MarquesMiranda D, da Silva AB, Sena Oliveira AC, Simoes-E-Silva AC. How is COVID-19 pandemic impacting mental health of children and adolescents? Int J Disaster Risk Reduct. 2020;51:101845.

    Google Scholar 

  34. Farooq S, Tunmore J, Ali W, Ayub M. Suicide, self-harm and suicidal ideation during COVID-19: a systematic review. Psychiatry Res. 2021;306:114228.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Mastromauro C, Blasetti A, Primavera M, Ceglie L, Mohn A, Chiarelli F, Giannini C. Peculiar characteristics of new-onset Type 1 Diabetes during COVID-19 pandemic. Ital J

  36. Cherubini V, Gohil A, Addala A, Zanfardino A, Iafusco D, Hannon T, et al. Unintended Consequences of Coronavirus Disease-2019: Remember General Pediatrics. J Pediatr. 2020;223:197–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Rabbone I, Schiafni R, Cherubini V, Mafeis C, Scaramuzza A. Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes .Has covid-19 delayed the diagnosis and worsened the presentation of type 1 diabetes in children? Diabetes Care. 2020;43:2870–2.

    CAS  PubMed  Google Scholar 

  38. Peinkhofer M, Bossini B, Penco A, Giangreco M, Pellegrin MC, Vidonis V, Vittori G, Grassi N, Faleschini E, Barbi E, Tornese G. Reduction in pediatric growth hormone deficiency and increase in central precocious puberty diagnoses during COVID 19 pandemics. Ital J Pediatr. 2022;48(1):49.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Umano GR, Maddaluno I, Riccio S, Lanzaro F, Antignani R, Giuliano M, Luongo C, Festa A, Miraglia Del Giudice E, Grandone A. Central precocious puberty during COVID-19 pandemic and sleep disturbance: an exploratory study. Ital J Pediatr. 2022;48(1):60.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Acar S, Özkan B. Increased frequency of idiopathic central precocious puberty in girls during the COVID-19 pandemic: preliminary results of a tertiary center study. J Pediatr Endocrinol Metab. 2021;35(2):249–51.

    PubMed  Google Scholar 

  41. Stagi S, De Masi S, Bencini E, Losi S, Paci S, Parpagnoli M, et al. Increased incidence of precocious and accelerated puberty in females during and after the Italian lockdown for the coronavirus 2019 (COVID-19) pandemic. Ital J Pediatr. 2020;46:165.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Verzani M, Bizzarri C, Chioma L, Bottaro G, Pedicelli S, Cappa M. Impact of COVID-19 pandemic lockdown on puberty: experience of an Italian tertiary center. Ital J Pediatr. 2021;47:52–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Yesiltepe Mutlu G, Eviz E, Haliloglu B, Kirmizibekmez H, Dursun F, Ozalkak S, Cayir A, Sacli BY, Ozbek MN, Demirbilek H, Hatun S. The effects of the covid-19 pandemic on puberty: a cross-sectional, multicenter study from Turkey. Ital J Pediatr. 2022;48(1):144.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Mameli C, Picca M, Buzzetti R, Pace ME, Badolato R, Cravidi C, Zuccotti GV, Marchisio P. Italian Society of Paediatrics Lombardy Section Incidence of acute respiratory infections in preschool children in an outpatient setting before and during Covid-19 pandemic in Lombardy Region, Italy. Ital J Pediatr. 2022;48(1):18.

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Leung NHL, Chu DKW, Shiu EYC, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med. 2020;26(5):676–80.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. World Health Organization, United Nations Children’s Fund (UNICEF) . Advice on the use of masks for children in the community in the context of COVID-19: annex to the advice on the use of masks in the context of COVID-19, 21 August 2020. https://www.who.int/publications/i/item/WHO-2019-nCoV-IPC_Masks-Children-2020.1.

  47. Heidarzadeh M, Taheri M, Mazaheripour Z, Abbasi-Khameneh F. The incidence of congenital anomalies in newborns before and during the Covid-19 pandemic. Ital J Pediatr. 2022;48(1):174.

    PubMed  PubMed Central  Google Scholar 

  48. Lindberg LD, VandeVusse A, Mueller J, Kirstein M. Early impacts of the COVID-19 pandemic: Findings from the 2020 Guttmacher Survey of Reproductive Health Experiences. New York, NY: Guttmacher Institute. 2020;10:31482.

    Google Scholar 

  49. Ahlers-Schmidt CR, Hervey AM, Neil T, Kuhlmann S, Kuhlmann Z. Concerns of women regarding pregnancy and childbirth during the COVID- 19 pandemic. Patient Educ Couns. 2020;103:12.

    Google Scholar 

  50. Lanari M, Venturini E, Pierantoni L, Stera G, Castelli Gattinara G, Esposito SMR, Favilli S, Franzoni E, Fusco E, Lionetti P, Maffeis C, Marseglia G, Massella L, Midulla F, Zanobini A, Zecca M, Villani A, Staiano A, Galli L. Other Collaborators Eligibility criteria for pediatric patients who may benefit from anti SARS-CoV-2 monoclonal antibody therapy administration: an Italian inter-society consensus statement. Ital J Pediatr. 2022;48(1):7.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Graff K, Smith C, Silveira L, Jung S, Curran-Hays S, Jarjour J, et al. Risk factors for severe COVID-19 in children. Pediatr Infect Dis J. 2021;40(4):E137–45. https://doi.org/10.1097/INF.0000000000003043.

    Article  PubMed  Google Scholar 

  52. Tsankov BK, Allaire JM, Irvine MA, Lopez AA, Sauvé LJ, Vallance BA, et al. Severe COVID-19 infection and pediatric comorbidities: a systematic review and Meta-analysis. Int J Infect Dis. 2021;103:246–56.

    CAS  PubMed  Google Scholar 

  53. Munblit D, Nicholson TR, Needham DM, Seylanova N, Parr C, Chen J, et al. Studying the post-COVID-19 condition: research challenges, strategies, and importance of core outcome set development. BMC Med. 2022;20:50.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Brindisi G, Zicari AM, Parisi GF, Diaferio L, Indolfi C, Marchese G, Ghiglioni DG, Umano GR, Klain A, Marseglia GL. Del Giudice MM Prevalence of COVID 19 in children affected by allergic rhinoconjunctivitis and asthma: results from the second “SIAIP rhinosinusitis and conjunctivitis committee” survey. Ital J Pediatr. 2022;48(1):1.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Chao JY, Derespina KR, Herold BC, Goldman DL, Aldrich M, Weingarten J, et al. Clinical characteristics and outcomes of hospitalized and critically ill children and adolescents with coronavirus disease 2019 at a tertiary care medical center in new York City. J Pediatr. 2020;223:14–9. https://doi.org/10.1016/j.jpeds.2020.05.006.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Morais-Almeida M, Pité H, Aguiar R, Ansotegui I, Bousquet J. Asthma and the Coronavirus Disease 2019 Pandemic: a literature review. Int Arch Allergy Immunol. 2020;181(9):680–8.

    CAS  PubMed  Google Scholar 

  57. Esposito S. Pediatricians of Emilia-Romagna Region, Italy Manifesto of the pediatricians of Emilia-Romagna region, Italy, in favor of vaccination against COVID in children 5–11 years old. Ital J Pediatr. 2022;48(1):40.

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Casini F, Magenes VC, De Sanctis M, Gattinara M, Pandolfi M, Cambiaghi S, Zuccotti GV, Fabiano V. Henoch-Schönlein purpura following COVID-19 vaccine in a child: a case report. Ital J Pediatr. 2022;48(1):158.

    PubMed  PubMed Central  Google Scholar 

  59. Mariani M, Caorsi R, Consolaro A, Brisca G, Sticchi C, Gattorno M, Castagnola E, Ravelli A. Protection against MIS-C outweighs the risk of myocarditis after Covid-19 vaccination in children. Ital J Pediatr. 2022;48(1):142.

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Hause AM, Baggs J, Marquez P, Myers TR, Gee J, Su JR, et al. COVID-19 vaccine safety in children aged 5–11 years - United States, November 3-December 19, 2021. MMWR Morb Mortal Wkly Rep. 2021;70:1755–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  61. Klein NP, Lewis N, Goddard K, Fireman B, Zerbo O, Hanson KE, et al. Surveillance for adverse events after COVID-19 mRNA vaccination. JAMA. 2021;326:1390–413.

    CAS  PubMed  Google Scholar 

  62. Novembre E, Tosca M, Caffarelli C, Calvani M, Cardinale F, Castagnoli R, Chiappini E, Cravidi C, Del Giudice MM, Duse M, Licari A, Manti S, Martelli A, Ricci G, Pingitore G, Marseglia GL. Management of BNT162b2 mRNA COVID-19 vaccine in children aged 5–11 years with allergies, asthma, and immunodeficiency: consensus of the Italian Society of Pediatric Allergy and Immunology (SIAIP). Ital J Pediatr. 2022;48(1):76.

    CAS  PubMed  PubMed Central  Google Scholar 

  63. Klain A, Indolfi C, Dinardo G, Decimo F, Miraglia Del Giudice M. Covid 19 and spirometry in this age. Ital J Pediatr. 2022;48(1):11.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Zhonghua Jie He He Hu Xi Za Zhi.Task Force of Pulmonary Function Testing, Clinical Respiratory Physiology, Chinese Association of Chest Physicians, Pulmonary Function Testing Group, Respiratory Therapeutics Group and Chinese Thoracic Society [Expert consensus on Pulmonary Function Testing during the epidemic of Coronavirus disease 2019] 2020;43:302 – 307.

  65. Esposito S, Giordano R, Paini G, Puntoni M, Principi N, Caminiti C. Can we get out of the COVID pandemic without adequate vaccination coverage in the pediatric population? Ital J Pediatr. 2022;48(1):150.

    CAS  PubMed  PubMed Central  Google Scholar 

  66. Wang L, Wen W, Chen C, Tang J, Wang C, Zhou M, Cheng Y, Zhang X, Wang M, Feng Z. Wang WExplore the attitudes of children and adolescent parents towards the vaccination of COVID-19 in China. Ital J Pediatr. 2022;48(1):122.

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Cai H, Bai W, Liu S, et al. Attitudes toward COVID-19 vaccines in Chinese adolescents. Front Med (Lausanne). 2021;8:691079.

    PubMed  Google Scholar 

  68. Zona S, Partesotti S, Bergomi A, et al. Anti-COVID vaccination for adolescents: a survey on determinants of vaccine parental hesitancy. Vaccines (Basel). 2021;9(11):1309.

    CAS  PubMed  Google Scholar 

  69. Cupertino V, Bozzola E, De Luca G, Del Giudice E, De Martino G, Cannataro P, Tozzi AE. Corsello G The awareness and acceptance of anti-COVID 19 vaccination in adolescence. Ital J Pediatr. 2022;48(1):194.

    PubMed  PubMed Central  Google Scholar 

  70. Principi N. Esposito S Reasons in favourof universal vaccination campaign against COVID-19 in the pediatric population. Ital J Pediatr. 2022;48(1):4.

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

Not applicable.

Author information

Authors and Affiliations

Authors

Contributions

GC, CC, FS coordinated the study; GC, CC, FS, EB conceived the study, participated in its design; CC, EB carried out the literature research CC, FS, EB, GC helped to draft the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Elena Bozzola.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

All the authors have a role of editor for Italian Journal of Pediatrics: GC is the Editor in Chief, CC and FS are Senior Editors, EB is associate Editor-Section Infectious Diseases and Vaccinology.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

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 original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bozzola, E., Caffarelli, C., Santamaria, F. et al. Year 2022: exploring COVID-19 pandemic in children. Ital J Pediatr 49, 128 (2023). https://doi.org/10.1186/s13052-023-01536-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s13052-023-01536-2

Keywords