Rivista di formazione e aggiornamento professionale del pediatra e del medico di base, fondata nel 1982. In collaborazione con l'Associazione Culturale Pediatri.
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Consensus

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Gestione del Covid-19 in età pediatrica: documento di consenso

Management of Covid-19 in the paediatric age: consensus document

Susanna Esposito1, Federico Marchetti2, Marcello Lanari3, Fabio Caramelli4, Alessandro De Fanti5, Gianluca Vergine6, Lorenzo Iughetti7, Martina Fornaro8, Agnese Suppiej9, Stefano Zona10, Andrea Pession11, Giacomo Biasucci12 per il Gruppo di Lavoro su Covid-19 in Pediatria della Regione Emilia-Romagna (RE-CO-PED)*

1Clinica Pediatrica, Azienda Ospedaliera-Universitaria, Università di Parma; 2UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna; 3UO Pediatria d’Urgenza, IRCCS Azienda Ospedaliero-Universitaria, Policlinico di S. Orsola, Bologna; 4UOC di Anestesia e Rianimazione Generale e Pediatrica, IRCCS Azienda Ospedaliero-Universitaria, Policlinico di S. Orsola, Bologna; 5UOC di Pediatria, Ospedale Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia; 6Unità di Pediatria, Ospedale di Rimini, AUSL della Romagna; 7UOC di Pediatria, D.A.I. Materno-infantile, Azienda Ospedaliero-Universitaria, Università di Modena e Reggio Emilia; 8UOC di Pediatria, Ospedale di Forlì, AUSL della Romagna; 9Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Università di Ferrara; 10Dipartimento di Cure Primarie, AUSL Modena; 11Clinica Pediatrica, IRCCS Ospedale Maggiore Policlinico Sant’Orsola, Università di Bologna; 12UOC di Pediatria e Neonatologia, Ospedale di Piacenza

Febbraio 2021 - pagg. 85 -101 | DOI: 10.53126/MEB40085

Abstract
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has rapidly spread, becoming the first pandemic of the 21st century by death toll. Children appear to be less affected than adults, with a milder clinical presentation and a significantly lower mortality rate. However, serious complica-tions can occur in childhood, such as COVID-19 temporally related multisystem inflammatory syn-drome (MIS-C). Some aspects of SARS-CoV-2 infection in children and adolescents remain un-clear and the optimal treatment has not been defined. The Working Group on COVID-19 in Paediatrics of the Emilia-Romagna Region (RE-CO-PED) has produced a consensus document with practical recommendations based on a systematic review of the literature and on the clinical experi-ence of the expert group. Evidence is reported regarding prevention measures, diagnostic tools as well as home and hospital therapeutic management of complicated cases (MIS-C). The educational and psychological effects of the pandemic in the paediatric and adolescent age are reported, with the need to define coordinated interventions (between paediatricians, neurospychiatrists, psycholo-gists and educational services) for the prevention and treatment of documented emotional, relational and educational consequences caused by the lockdown, school closures and social distances.
Riassunto
La malattia da Coronavirus 2019 (Covid-19) causata da SARS-CoV-2 si è rapidamente diffusa, diventando la prima pandemia del 21° secolo per numero di morti. I bambini sembrano essere meno colpiti rispetto agli adulti, con una presentazione clinica più lieve e un tasso di mortalità significativamente inferiore. Tuttavia, in età pediatrica possono verificarsi gravi complicanze, come la sindrome infiammatoria multisistemica temporalmente correlata a COVID-19 (MIS-C). Alcuni aspetti dell'infezione da SARS-CoV-2 nei bambini e negli adolescenti rimangono poco chiari e il tratta-mento ottimale non è stato definito. Il Gruppo di Lavoro su Covid-19 in Pediatria della Regione Emilia-Romagna (RE-CO-PED) ha prodotto un documento di consenso con raccomandazioni pratiche basate su una revisione sistematica della letteratura e sull'esperienza clinica del gruppo di esperti. Sono riportate le evidenze in merito alle misure di prevenzione, agli strumenti di diagnosi, alla gestione terapeutica territoriale e ospedaliera dei casi sintomatici e di quelli complicati (MIS-C). Si riportano le ricadute sul piano educativo e psicologico della pandemia in età pediatrica e adolescenziale, con la necessità di definire interventi coordinati (tra pediatri, neuropsichiatri, psicologi, servizi educativi) per la prevenzione e il trattamento delle documentate conseguenze emozionali, relazionali e educative causate dal lockdown, dalle chiusure scolastiche e dalle distanze sociali.
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