OctoberFAST: segni e sintomi dei bambini sottoposti a tampone per SARS-CoV-2

Abstract

Background - From the beginning of the SARS-CoV-2 outbreak one major issue has been the early identification of infectious cases. It is particularly challenging to perform a symptom-based screening in the paediatric population because of the seeming overlap of early clinical manifestations between Covid-19 and other common viral infections. Aims - This study was aimed to assess the likelihood that clinical scenarios driving to the SARS-CoV-2 molecular swab test (SMST) might be suggestive for Covid-19 in children. Materials and methods - A survey was proposed to the family paediatricians of the Province of Bergamo (Italy). For all the patients referred for SMST due to symptoms in the period 28/Sep/2020 - 31/Oct/2020, the request was to gather the following data: symptoms, outcome of the SMST, school level, and period between onset of symptom/s and SMST. Data were centralised in anonymous format, making use of pivot-table with aggregate data for final statistical analysis. Results - Data were exploitable for 75 family paediatricians, for a total 3,093 SMST. SMST were positive in 119 cases (3.85%). The rate of SMST positivity was: 1) higher when the interval between symptoms and SMST was shorter than 24h; 2) slightly higher at middle school vs. pre-school or elementary school. Among the observed symptoms, a robust positive association with SMST positivity was observed (OR = 7.77) with a high PPV (22.5%) only for anosmia/ageusia. Conclusion - Although this study detected a few more suggestive signs/symptoms for Covid-19 with respect to other common viral illnesses, a symptom-based screening for SARS-CoV-2 appears less effective to flush out the virus in children. The estimation of the pre-test probability should also rely on the concurrent evaluation of the epidemiological setting.