{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:13:39Z","timestamp":1788401619818,"version":"build-2803163510"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Pre-existing medical conditions are known to increase the risk of severe coronavirus disease 2019 (COVID-19), even in pediatric populations. This study aimed to evaluate the symptoms and severity of COVID-19, as well as the side effects of the BNT162 vaccine, in children and adolescents with Noonan Syndrome (\n                      <jats:italic>N<\/jats:italic>\n                      S) compared to healthy controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective and prospective multicenter study was conducted across Italy. Clinical characteristics, course, and duration of SARS-CoV-2 infection, as well as side effects of the BNT162 vaccine, were compared between 97 patients with NS and 97 age- and sex-matched healthy subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No statistically significant differences were found in the severity or duration of COVID-19 between NS patients and controls. NS patients exhibited a higher rate of rhinorrhea during SARS-CoV-2 infection (69.2% vs. 46%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), whereas anosmia was more common among controls (1.5% vs. 12.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). No statistically significant differences in side effects from the BNT162 vaccine were observed between groups. 95% confidence intervals were calculated for key outcomes to improve comparability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children and adolescents with Noonan Syndrome generally experience a mild course of COVID-19 and show no evidence of increased vaccine-related risk. Despite the small sample size and the rarity of severe events, these findings yield valuable insights for patients living with this rare disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1658340","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:57:48Z","timestamp":1768204668000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence and severity of SARS-CoV-2 infection and vaccine BNT162 side effects in children and adolescents with Noonan Syndrome: a national multicentric study"],"prefix":"10.3389","volume":"13","author":[{"given":"Sarah","family":"Dal Ben","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Tamburrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bonomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Scarano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Orlandini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Pozzobon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Giavoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Corezzola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Felicia","family":"Faienza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppa","family":"Patti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Capalbo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariacarolina","family":"Salerno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Franceschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Longhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata Gabriela","family":"Wasniewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Corica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Zoller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Piazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Maghnie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Antoniazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Gaudino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","year":""},{"key":"B2","year":""},{"key":"B3","year":""},{"key":"B4","year":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/jpc.15811","article-title":"COVID-19 in children. 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