Characteristics and management of patients with SARS-CoV2 infection admitted to pediatric intensive care units: Data analysis of the Spanish national multicenter registry
Por:
Slocker-Barrio M, Belda-Hofheinz S, Guitart-Pardellans C, Garcia-Salido, A, de Carlos-Vicente JC, Cuervas-Mons M, Hernandez-Yuste A, Jimenez-Olmos A, Morteruel-Arizcuren E, Garcia-Besteiro, M, Calvo-Monge C, Rodriguez-Rubio M, Roca-Pascual D, Bermudez-Barrezueta L, Martinez-Padilla C, Labarga, BH, Oulego-Erroz, I, Sanchiz-Cardenas S, Rey-Galan C, Holanda-Pena MS, Gonzalez-Navarro P and Gonzalez-Cortes R
Publicada:
1 oct 2023
Ahead of Print:
1 jul 2023
Resumen:
IntroductionThe purpose of this study is to describe the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) disease characteristics and management in children admitted to the pediatric intensive care units (PICU). MethodsThe present study was based on a national multicentric prospective registry including PICU patients with SARS-CoV2 infection or symptoms of multisystem inflammatory syndrome in children (MIS-C). ResultsA total of 298 patients were admitted to 41 different Spanish PICUs. A total of 76% of them were previously healthy. The most frequent manifestation was MIS-C (69.8%). On admission, 59.4% of patients did not have respiratory distress, and only 17.4% needed conventional mechanical ventilation (MV). The need for MV was associated with age (incidence rate ratios [IRR] 1.21, p < .012), pediatric sequential organ failure assessment score (p-SOFA) Score (IRR 1.12, p = .001), and need for transfusion (IRR 4.5, p < .004) in MIS-C patients, and with vasoactive drug use (IRR 2.73, p = .022) and the diagnosis of acute respiratory distress syndrome (IRR 2.83, p = .018) in patients admitted for other reasons. During the first day of admission, 56% of patients met shock criteria and 50.7% needed vasoactive drugs. In MIS-C patients, their use was associated with higher p-SOFA score (IRR 1.06, p < .001) and with the diagnosis of shock (IRR 5.78, p < .001). In patients without MIS-C, it was associated with higher p-SOFA score (IRR 1.05, p = .022). The mortality rate was 3%, being lower in MIS-C patients compared to patients admitted for other reasons (0.5% vs. 9.4%, p < .001). It was also lower in previously healthy patients compared to patients with previous comorbidities (0.9% vs. 9.7%, p < .001). ConclusionsSevere SARS-CoV2 infection is uncommon in the pediatric population. In our series, respiratory distress was rare, being MIS-C the most frequent cause of PICU admission related to SARS-CoV2. In most cases, the course of the disease was mild except in children with previous diseases.
Filiaciones:
Slocker-Barrio M:
Inst Salud Carlos III, Primary Care Intervent Prevent Maternal & Child C, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Pediat Intens Care Unit, Madrid, Spain
Univ Complutense Madrid, Publ Hlth & Maternal & Child Dept, Madrid, Spain
Belda-Hofheinz S:
Univ Complutense Madrid, Publ Hlth & Maternal & Child Dept, Madrid, Spain
Hosp Univ 12 Octubre, Pediat Intens Care Unit, Madrid, Spain
Guitart-Pardellans C:
Hosp Univ Sant Joan De Deu, Pediat Intens Care Unit, Barcelona, Spain
Garcia-Salido, A:
Hosp Univ Nino Jesus, Pediat Intens Care Unit, Madrid, Spain
de Carlos-Vicente JC:
Hosp Univ Son Espases, Pediat Intens Care Unit, Palma De Mallorca, Spain
Cuervas-Mons M:
Complejo Asistencial Univ Burgos, Pediat Intens Care Unit, Burgos, Spain
Hernandez-Yuste A:
Hosp Materno Infantil Univ Malaga, Pediat Intens Care Unit, Malaga, Spain
Jimenez-Olmos A:
Hosp Univ Miguel Servet, Pediat Intens Care Unit, Zaragoza, Spain
Morteruel-Arizcuren E:
Hosp Univ Cruces, Pediat Intens Care Unit, Baracaldo, Spain
Garcia-Besteiro, M:
Corp Sanitaria Parc Tauli, Pediat Intens Care Unit, Sabadell, Spain
Calvo-Monge C:
Hosp Univ Donostia, Pediat Intens Care Unit, San Sebastian, Spain
Rodriguez-Rubio M:
Hosp Univ La Paz, Pediat Intens Care Unit, Madrid, Spain
Roca-Pascual D:
Campus Hosp Vall dHebron, Pediat Intens Care Unit, Barcelona, Spain
Bermudez-Barrezueta L:
Hosp Clin Univ Valladolid, Pediat Intens Care Unit, Valladolid, Spain
Martinez-Padilla C:
Hosp Univ Jaen, Pediat Intens Care Unit, Jaen, Spain
Labarga, BH:
Complejo Hosp Univ Toledo, Pediat Intens Care Unit, Toledo, Spain
Oulego-Erroz, I:
Complejo Asistencial Univ Leon, Pediat Intens Care Unit, Leon, Spain
Sanchiz-Cardenas S:
Hosp Univ Virgen Arrixaca, Pediat Intens Care Unit, Murcia, Spain
Rey-Galan C:
Hosp Univ Cent Asturias, Pediat Intens Care Unit, Oviedo, Spain
Holanda-Pena MS:
Hosp Univ Marques Valdecilla, Pediat Intens Care Unit, Santander, Spain
Gonzalez-Navarro P:
Gregorio Maranon Hlth Res Inst, Methodol & Biostat Unit, Madrid, Spain
Gonzalez-Cortes R:
Inst Salud Carlos III, Primary Care Intervent Prevent Maternal & Child C, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Pediat Intens Care Unit, Madrid, Spain
Univ Complutense Madrid, Publ Hlth & Maternal & Child Dept, Madrid, Spain
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