COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.
Identifieur interne : 001289 ( Main/Corpus ); précédent : 001288; suivant : 001290COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.
Auteurs : Florian Götzinger ; Bego A Santiago-García ; Antoni Noguera-Julián ; Miguel Lanaspa ; Laura Lancella ; Francesca I. Cal Carducci ; Natalia Gabrovska ; Svetlana Velizarova ; Petra Prunk ; Veronika Osterman ; Uros Krivec ; Andrea Lo Vecchio ; Delane Shingadia ; Antoni Soriano-Arandes ; Susana Melendo ; Marcello Lanari ; Luca Pierantoni ; Noémie Wagner ; Arnaud G. L'Huillier ; Ulrich Heininger ; Nicole Ritz ; Srini Bandi ; Nina Krajcar ; Sr An Rogli ; Mar Santos ; Christelle Christiaens ; Marine Creuven ; Danilo Buonsenso ; Steven B. Welch ; Matthias Bogyi ; Folke Brinkmann ; Marc TebrueggeSource :
- The Lancet. Child & adolescent health [ 2352-4650 ] ; 2020.
English descriptors
- KwdEn :
- Betacoronavirus (MeSH), COVID-19 (MeSH), Child (MeSH), Child, Preschool (MeSH), Coronavirus Infections (epidemiology), Coronavirus Infections (therapy), Delivery of Health Care (organization & administration), Europe (epidemiology), Female (MeSH), Follow-Up Studies (MeSH), Humans (MeSH), Infant (MeSH), Infant, Newborn (MeSH), Intensive Care Units (organization & administration), Male (MeSH), Pandemics (MeSH), Patient Admission (trends), Pneumonia, Viral (epidemiology), Pneumonia, Viral (therapy), Risk Factors (MeSH), SARS-CoV-2 (MeSH).
- MESH :
- geographic , epidemiology : Europe.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- organization & administration : Delivery of Health Care, Intensive Care Units.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- trends : Patient Admission.
- Betacoronavirus, COVID-19, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Pandemics, Risk Factors, SARS-CoV-2.
Abstract
BACKGROUND
To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic.
METHODS
This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network-the Paediatric Tuberculosis Network European Trials Group (ptbnet)-that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission.
FINDINGS
582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5-12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2-11, range 1-34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5·06, 95% CI 1·72-14·87; p=0·0035), male sex (2·12, 1·06-4·21; p=0·033), pre-existing medical conditions (3·27, 1·67-6·42; p=0·0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10·46, 5·16-21·23; p<0·0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir-ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0·69%, 95% CI 0·20-1·82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support.
INTERPRETATION
COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed.
FUNDING
ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit.
DOI: 10.1016/S2352-4642(20)30177-2
PubMed: 32593339
PubMed Central: PMC7316447
Links to Exploration step
pubmed:32593339Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.</title><author><name sortKey="Gotzinger, Florian" sort="Gotzinger, Florian" uniqKey="Gotzinger F" first="Florian" last="Götzinger">Florian Götzinger</name><affiliation><nlm:affiliation>Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Wilhelminenspital, Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Santiago Garcia, Bego A" sort="Santiago Garcia, Bego A" uniqKey="Santiago Garcia B" first="Bego A" last="Santiago-García">Bego A Santiago-García</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Noguera Julian, Antoni" sort="Noguera Julian, Antoni" uniqKey="Noguera Julian A" first="Antoni" last="Noguera-Julián">Antoni Noguera-Julián</name><affiliation><nlm:affiliation>Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain; Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lanaspa, Miguel" sort="Lanaspa, Miguel" uniqKey="Lanaspa M" first="Miguel" last="Lanaspa">Miguel Lanaspa</name><affiliation><nlm:affiliation>Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lancella, Laura" sort="Lancella, Laura" uniqKey="Lancella L" first="Laura" last="Lancella">Laura Lancella</name><affiliation><nlm:affiliation>Academic Department of Paediatrics, Bambino Gesù Children's Hospital, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Cal Carducci, Francesca I" sort="Cal Carducci, Francesca I" uniqKey="Cal Carducci F" first="Francesca I" last="Cal Carducci">Francesca I. Cal Carducci</name><affiliation><nlm:affiliation>Academic Department of Paediatrics, Bambino Gesù Children's Hospital, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gabrovska, Natalia" sort="Gabrovska, Natalia" uniqKey="Gabrovska N" first="Natalia" last="Gabrovska">Natalia Gabrovska</name><affiliation><nlm:affiliation>Children's Clinic, Department of Pulmonary Diseases, MHATLD "St Sofia", Medical University Sofia, Sofia, Bulgaria.</nlm:affiliation></affiliation></author><author><name sortKey="Velizarova, Svetlana" sort="Velizarova, Svetlana" uniqKey="Velizarova S" first="Svetlana" last="Velizarova">Svetlana Velizarova</name><affiliation><nlm:affiliation>Children's Clinic, Department of Pulmonary Diseases, MHATLD "St Sofia", Medical University Sofia, Sofia, Bulgaria.</nlm:affiliation></affiliation></author><author><name sortKey="Prunk, Petra" sort="Prunk, Petra" uniqKey="Prunk P" first="Petra" last="Prunk">Petra Prunk</name><affiliation><nlm:affiliation>Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.</nlm:affiliation></affiliation></author><author><name sortKey="Osterman, Veronika" sort="Osterman, Veronika" uniqKey="Osterman V" first="Veronika" last="Osterman">Veronika Osterman</name><affiliation><nlm:affiliation>Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.</nlm:affiliation></affiliation></author><author><name sortKey="Krivec, Uros" sort="Krivec, Uros" uniqKey="Krivec U" first="Uros" last="Krivec">Uros Krivec</name><affiliation><nlm:affiliation>Department of Paediatric Pulmonology, University Medical Centre Ljubljana, Ljubljana, Slovenia.</nlm:affiliation></affiliation></author><author><name sortKey="Lo Vecchio, Andrea" sort="Lo Vecchio, Andrea" uniqKey="Lo Vecchio A" first="Andrea" last="Lo Vecchio">Andrea Lo Vecchio</name><affiliation><nlm:affiliation>Section of Paediatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Shingadia, Delane" sort="Shingadia, Delane" uniqKey="Shingadia D" first="Delane" last="Shingadia">Delane Shingadia</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, UK; Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Soriano Arandes, Antoni" sort="Soriano Arandes, Antoni" uniqKey="Soriano Arandes A" first="Antoni" last="Soriano-Arandes">Antoni Soriano-Arandes</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Melendo, Susana" sort="Melendo, Susana" uniqKey="Melendo S" first="Susana" last="Melendo">Susana Melendo</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lanari, Marcello" sort="Lanari, Marcello" uniqKey="Lanari M" first="Marcello" last="Lanari">Marcello Lanari</name><affiliation><nlm:affiliation>Medical and Surgical Science Department, S Orsola University Hospital, Bologna, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pierantoni, Luca" sort="Pierantoni, Luca" uniqKey="Pierantoni L" first="Luca" last="Pierantoni">Luca Pierantoni</name><affiliation><nlm:affiliation>Medical and Surgical Science Department, S Orsola University Hospital, Bologna, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Wagner, Noemie" sort="Wagner, Noemie" uniqKey="Wagner N" first="Noémie" last="Wagner">Noémie Wagner</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="L Huillier, Arnaud G" sort="L Huillier, Arnaud G" uniqKey="L Huillier A" first="Arnaud G" last="L'Huillier">Arnaud G. L'Huillier</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Heininger, Ulrich" sort="Heininger, Ulrich" uniqKey="Heininger U" first="Ulrich" last="Heininger">Ulrich Heininger</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Ritz, Nicole" sort="Ritz, Nicole" uniqKey="Ritz N" first="Nicole" last="Ritz">Nicole Ritz</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland; Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bandi, Srini" sort="Bandi, Srini" uniqKey="Bandi S" first="Srini" last="Bandi">Srini Bandi</name><affiliation><nlm:affiliation>Department of Paediatrics, Leicester Children's Hospital, Leicester, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Krajcar, Nina" sort="Krajcar, Nina" uniqKey="Krajcar N" first="Nina" last="Krajcar">Nina Krajcar</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.</nlm:affiliation></affiliation></author><author><name sortKey="Rogli, Sr An" sort="Rogli, Sr An" uniqKey="Rogli S" first="Sr An" last="Rogli">Sr An Rogli</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.</nlm:affiliation></affiliation></author><author><name sortKey="Santos, Mar" sort="Santos, Mar" uniqKey="Santos M" first="Mar" last="Santos">Mar Santos</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Christiaens, Christelle" sort="Christiaens, Christelle" uniqKey="Christiaens C" first="Christelle" last="Christiaens">Christelle Christiaens</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, CHC Montlegia, Liège, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Creuven, Marine" sort="Creuven, Marine" uniqKey="Creuven M" first="Marine" last="Creuven">Marine Creuven</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, CHC Montlegia, Liège, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Buonsenso, Danilo" sort="Buonsenso, Danilo" uniqKey="Buonsenso D" first="Danilo" last="Buonsenso">Danilo Buonsenso</name><affiliation><nlm:affiliation>Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Welch, Steven B" sort="Welch, Steven B" uniqKey="Welch S" first="Steven B" last="Welch">Steven B. Welch</name><affiliation><nlm:affiliation>Birmingham Chest Clinic and Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bogyi, Matthias" sort="Bogyi, Matthias" uniqKey="Bogyi M" first="Matthias" last="Bogyi">Matthias Bogyi</name><affiliation><nlm:affiliation>Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Wilhelminenspital, Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Brinkmann, Folke" sort="Brinkmann, Folke" uniqKey="Brinkmann F" first="Folke" last="Brinkmann">Folke Brinkmann</name><affiliation><nlm:affiliation>Department of Paediatric Pulmonology, Ruhr University Bochum, Bochum, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Tebruegge, Marc" sort="Tebruegge, Marc" uniqKey="Tebruegge M" first="Marc" last="Tebruegge">Marc Tebruegge</name><affiliation><nlm:affiliation>Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia; Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address: m.tebruegge@ucl.ac.uk.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32593339</idno><idno type="pmid">32593339</idno><idno type="doi">10.1016/S2352-4642(20)30177-2</idno><idno type="pmc">PMC7316447</idno><idno type="wicri:Area/Main/Corpus">001289</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001289</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.</title><author><name sortKey="Gotzinger, Florian" sort="Gotzinger, Florian" uniqKey="Gotzinger F" first="Florian" last="Götzinger">Florian Götzinger</name><affiliation><nlm:affiliation>Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Wilhelminenspital, Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Santiago Garcia, Bego A" sort="Santiago Garcia, Bego A" uniqKey="Santiago Garcia B" first="Bego A" last="Santiago-García">Bego A Santiago-García</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Noguera Julian, Antoni" sort="Noguera Julian, Antoni" uniqKey="Noguera Julian A" first="Antoni" last="Noguera-Julián">Antoni Noguera-Julián</name><affiliation><nlm:affiliation>Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain; Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lanaspa, Miguel" sort="Lanaspa, Miguel" uniqKey="Lanaspa M" first="Miguel" last="Lanaspa">Miguel Lanaspa</name><affiliation><nlm:affiliation>Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lancella, Laura" sort="Lancella, Laura" uniqKey="Lancella L" first="Laura" last="Lancella">Laura Lancella</name><affiliation><nlm:affiliation>Academic Department of Paediatrics, Bambino Gesù Children's Hospital, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Cal Carducci, Francesca I" sort="Cal Carducci, Francesca I" uniqKey="Cal Carducci F" first="Francesca I" last="Cal Carducci">Francesca I. Cal Carducci</name><affiliation><nlm:affiliation>Academic Department of Paediatrics, Bambino Gesù Children's Hospital, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gabrovska, Natalia" sort="Gabrovska, Natalia" uniqKey="Gabrovska N" first="Natalia" last="Gabrovska">Natalia Gabrovska</name><affiliation><nlm:affiliation>Children's Clinic, Department of Pulmonary Diseases, MHATLD "St Sofia", Medical University Sofia, Sofia, Bulgaria.</nlm:affiliation></affiliation></author><author><name sortKey="Velizarova, Svetlana" sort="Velizarova, Svetlana" uniqKey="Velizarova S" first="Svetlana" last="Velizarova">Svetlana Velizarova</name><affiliation><nlm:affiliation>Children's Clinic, Department of Pulmonary Diseases, MHATLD "St Sofia", Medical University Sofia, Sofia, Bulgaria.</nlm:affiliation></affiliation></author><author><name sortKey="Prunk, Petra" sort="Prunk, Petra" uniqKey="Prunk P" first="Petra" last="Prunk">Petra Prunk</name><affiliation><nlm:affiliation>Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.</nlm:affiliation></affiliation></author><author><name sortKey="Osterman, Veronika" sort="Osterman, Veronika" uniqKey="Osterman V" first="Veronika" last="Osterman">Veronika Osterman</name><affiliation><nlm:affiliation>Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.</nlm:affiliation></affiliation></author><author><name sortKey="Krivec, Uros" sort="Krivec, Uros" uniqKey="Krivec U" first="Uros" last="Krivec">Uros Krivec</name><affiliation><nlm:affiliation>Department of Paediatric Pulmonology, University Medical Centre Ljubljana, Ljubljana, Slovenia.</nlm:affiliation></affiliation></author><author><name sortKey="Lo Vecchio, Andrea" sort="Lo Vecchio, Andrea" uniqKey="Lo Vecchio A" first="Andrea" last="Lo Vecchio">Andrea Lo Vecchio</name><affiliation><nlm:affiliation>Section of Paediatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Shingadia, Delane" sort="Shingadia, Delane" uniqKey="Shingadia D" first="Delane" last="Shingadia">Delane Shingadia</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, UK; Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Soriano Arandes, Antoni" sort="Soriano Arandes, Antoni" uniqKey="Soriano Arandes A" first="Antoni" last="Soriano-Arandes">Antoni Soriano-Arandes</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Melendo, Susana" sort="Melendo, Susana" uniqKey="Melendo S" first="Susana" last="Melendo">Susana Melendo</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lanari, Marcello" sort="Lanari, Marcello" uniqKey="Lanari M" first="Marcello" last="Lanari">Marcello Lanari</name><affiliation><nlm:affiliation>Medical and Surgical Science Department, S Orsola University Hospital, Bologna, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pierantoni, Luca" sort="Pierantoni, Luca" uniqKey="Pierantoni L" first="Luca" last="Pierantoni">Luca Pierantoni</name><affiliation><nlm:affiliation>Medical and Surgical Science Department, S Orsola University Hospital, Bologna, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Wagner, Noemie" sort="Wagner, Noemie" uniqKey="Wagner N" first="Noémie" last="Wagner">Noémie Wagner</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="L Huillier, Arnaud G" sort="L Huillier, Arnaud G" uniqKey="L Huillier A" first="Arnaud G" last="L'Huillier">Arnaud G. L'Huillier</name><affiliation><nlm:affiliation>Paediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Heininger, Ulrich" sort="Heininger, Ulrich" uniqKey="Heininger U" first="Ulrich" last="Heininger">Ulrich Heininger</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Ritz, Nicole" sort="Ritz, Nicole" uniqKey="Ritz N" first="Nicole" last="Ritz">Nicole Ritz</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland; Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bandi, Srini" sort="Bandi, Srini" uniqKey="Bandi S" first="Srini" last="Bandi">Srini Bandi</name><affiliation><nlm:affiliation>Department of Paediatrics, Leicester Children's Hospital, Leicester, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Krajcar, Nina" sort="Krajcar, Nina" uniqKey="Krajcar N" first="Nina" last="Krajcar">Nina Krajcar</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.</nlm:affiliation></affiliation></author><author><name sortKey="Rogli, Sr An" sort="Rogli, Sr An" uniqKey="Rogli S" first="Sr An" last="Rogli">Sr An Rogli</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.</nlm:affiliation></affiliation></author><author><name sortKey="Santos, Mar" sort="Santos, Mar" uniqKey="Santos M" first="Mar" last="Santos">Mar Santos</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Christiaens, Christelle" sort="Christiaens, Christelle" uniqKey="Christiaens C" first="Christelle" last="Christiaens">Christelle Christiaens</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, CHC Montlegia, Liège, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Creuven, Marine" sort="Creuven, Marine" uniqKey="Creuven M" first="Marine" last="Creuven">Marine Creuven</name><affiliation><nlm:affiliation>Department of Paediatric Infectious Diseases, CHC Montlegia, Liège, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Buonsenso, Danilo" sort="Buonsenso, Danilo" uniqKey="Buonsenso D" first="Danilo" last="Buonsenso">Danilo Buonsenso</name><affiliation><nlm:affiliation>Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Welch, Steven B" sort="Welch, Steven B" uniqKey="Welch S" first="Steven B" last="Welch">Steven B. Welch</name><affiliation><nlm:affiliation>Birmingham Chest Clinic and Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bogyi, Matthias" sort="Bogyi, Matthias" uniqKey="Bogyi M" first="Matthias" last="Bogyi">Matthias Bogyi</name><affiliation><nlm:affiliation>Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Wilhelminenspital, Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Brinkmann, Folke" sort="Brinkmann, Folke" uniqKey="Brinkmann F" first="Folke" last="Brinkmann">Folke Brinkmann</name><affiliation><nlm:affiliation>Department of Paediatric Pulmonology, Ruhr University Bochum, Bochum, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Tebruegge, Marc" sort="Tebruegge, Marc" uniqKey="Tebruegge M" first="Marc" last="Tebruegge">Marc Tebruegge</name><affiliation><nlm:affiliation>Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia; Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address: m.tebruegge@ucl.ac.uk.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The Lancet. Child & adolescent health</title><idno type="eISSN">2352-4650</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (therapy)</term><term>Delivery of Health Care (organization & administration)</term><term>Europe (epidemiology)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Humans (MeSH)</term><term>Infant (MeSH)</term><term>Infant, Newborn (MeSH)</term><term>Intensive Care Units (organization & administration)</term><term>Male (MeSH)</term><term>Pandemics (MeSH)</term><term>Patient Admission (trends)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (therapy)</term><term>Risk Factors (MeSH)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Europe</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Delivery of Health Care</term><term>Intensive Care Units</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Patient Admission</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>COVID-19</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term><term>Pandemics</term><term>Risk Factors</term><term>SARS-CoV-2</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network-the Paediatric Tuberculosis Network European Trials Group (ptbnet)-that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission.</p></div><div type="abstract" xml:lang="en"><p><b>FINDINGS</b></p><p>582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5-12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2-11, range 1-34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5·06, 95% CI 1·72-14·87; p=0·0035), male sex (2·12, 1·06-4·21; p=0·033), pre-existing medical conditions (3·27, 1·67-6·42; p=0·0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10·46, 5·16-21·23; p<0·0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir-ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0·69%, 95% CI 0·20-1·82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support.</p></div><div type="abstract" xml:lang="en"><p><b>INTERPRETATION</b></p><p>COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed.</p></div><div type="abstract" xml:lang="en"><p><b>FUNDING</b></p><p>ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32593339</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>01</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2352-4650</ISSN><JournalIssue CitedMedium="Internet"><Volume>4</Volume><Issue>9</Issue><PubDate><Year>2020</Year><Month>09</Month></PubDate></JournalIssue><Title>The Lancet. Child & adolescent health</Title><ISOAbbreviation>Lancet Child Adolesc Health</ISOAbbreviation></Journal><ArticleTitle>COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.</ArticleTitle><Pagination><MedlinePgn>653-661</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S2352-4642(20)30177-2</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/S2352-4642(20)30177-2</ELocationID><Abstract><AbstractText Label="BACKGROUND">To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic.</AbstractText><AbstractText Label="METHODS">This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network-the Paediatric Tuberculosis Network European Trials Group (ptbnet)-that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission.</AbstractText><AbstractText Label="FINDINGS">582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5-12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2-11, range 1-34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5·06, 95% CI 1·72-14·87; p=0·0035), male sex (2·12, 1·06-4·21; p=0·033), pre-existing medical conditions (3·27, 1·67-6·42; p=0·0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10·46, 5·16-21·23; p<0·0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir-ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0·69%, 95% CI 0·20-1·82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support.</AbstractText><AbstractText Label="INTERPRETATION">COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed.</AbstractText><AbstractText Label="FUNDING">ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit.</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Götzinger</LastName><ForeName>Florian</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Wilhelminenspital, Vienna, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Santiago-García</LastName><ForeName>Begoña</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Noguera-Julián</LastName><ForeName>Antoni</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain; Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lanaspa</LastName><ForeName>Miguel</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lancella</LastName><ForeName>Laura</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Academic Department of Paediatrics, Bambino Gesù Children's Hospital, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Calò Carducci</LastName><ForeName>Francesca I</ForeName><Initials>FI</Initials><AffiliationInfo><Affiliation>Academic Department of Paediatrics, Bambino Gesù Children's Hospital, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gabrovska</LastName><ForeName>Natalia</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Children's Clinic, Department of Pulmonary Diseases, MHATLD "St Sofia", Medical University Sofia, Sofia, Bulgaria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Velizarova</LastName><ForeName>Svetlana</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Children's Clinic, Department of Pulmonary Diseases, MHATLD "St Sofia", Medical University Sofia, Sofia, Bulgaria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prunk</LastName><ForeName>Petra</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Osterman</LastName><ForeName>Veronika</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krivec</LastName><ForeName>Uros</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Paediatric Pulmonology, University Medical Centre Ljubljana, Ljubljana, Slovenia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lo Vecchio</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Section of Paediatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shingadia</LastName><ForeName>Delane</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, UK; Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Soriano-Arandes</LastName><ForeName>Antoni</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Melendo</LastName><ForeName>Susana</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lanari</LastName><ForeName>Marcello</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Medical and Surgical Science Department, S Orsola University Hospital, Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pierantoni</LastName><ForeName>Luca</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Medical and Surgical Science Department, S Orsola University Hospital, Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wagner</LastName><ForeName>Noémie</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Paediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>L'Huillier</LastName><ForeName>Arnaud G</ForeName><Initials>AG</Initials><AffiliationInfo><Affiliation>Paediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heininger</LastName><ForeName>Ulrich</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ritz</LastName><ForeName>Nicole</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland; Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bandi</LastName><ForeName>Srini</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Paediatrics, Leicester Children's Hospital, Leicester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krajcar</LastName><ForeName>Nina</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roglić</LastName><ForeName>Srđan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Santos</LastName><ForeName>Mar</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Christiaens</LastName><ForeName>Christelle</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases, CHC Montlegia, Liège, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Creuven</LastName><ForeName>Marine</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Paediatric Infectious Diseases, CHC Montlegia, Liège, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Buonsenso</LastName><ForeName>Danilo</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Welch</LastName><ForeName>Steven B</ForeName><Initials>SB</Initials><AffiliationInfo><Affiliation>Birmingham Chest Clinic and Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bogyi</LastName><ForeName>Matthias</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Wilhelminenspital, Vienna, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brinkmann</LastName><ForeName>Folke</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Paediatric Pulmonology, Ruhr University Bochum, Bochum, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tebruegge</LastName><ForeName>Marc</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia; Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address: m.tebruegge@ucl.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>ptbnet COVID-19 Study Group</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Lancet Child Adolesc Health</MedlineTA><NlmUniqueID>101712925</NlmUniqueID><ISSNLinking>2352-4642</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" 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