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- Title
Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study.
- Authors
Prata-Barbosa, Arnaldo; Lima-Setta, Fernanda; Rodrigues dos Santos, Gustavo; Soares Lanziotti, Vanessa; Vieira de Castro, Roberta Esteves; Carla de Souza, Daniela; Eduardo Raymundo, Carlos; Caino de Oliveira, Felipe Rezende; Peixoto de Lima, Lucio Flavio; Tedesco Tonial, Cristian; Colleti Jr., José; Novaes Bellinat, Ana Paula; Botelho Lorenzo, Vivian; de Seixas Zeitel, Raquel; Pulcheri, Lucas; Monte da Costa, Fernanda Ciuffo; Ferreira La Torre, Fabíola Peixoto; das Neves Figueiredo, Elaine Augusta; Peres da Silva, Thiago; Marins Riveiro, Paula
- Abstract
Objective: To describe the clinical characteristics of children and adolescents admitted to intensive care with confirmed COVID-19. Method: Prospective, multicenter, observational study, in 19 pediatric intensive care units. Patients aged 1 month to 19 years admitted consecutively (March--May 2020) were included. Demographic, clinical-epidemiological features, treatment, and outcomes were collected. Subgroups were compared according to comorbidities, age < 1 year, and need for invasive mechanical ventilation. A multivariable logistic regression model was used for predictors of severity. Results: Seventy-nine patients were included (ten with multisystemic inflammatory syndrome). Median age 4 years; 54% male (multisystemic inflammatory syndrome, 80%); 41% had comorbidities (multisystemic inflammatory syndrome, 20%). Fever (76%), cough (51%), and tachypnea (50%) were common in both groups. Severe symptoms, gastrointestinal symptoms, and higher inflammatory markers were more frequent in multisystemic inflammatory syndrome. Interstitial lung infiltrates were common in both groups, but pleural effusion was more prevalent in the multisystemic inflammatory syndrome group (43% vs. 14%). Invasive mechanical ventilation was used in 18% (median 7.5 days); antibiotics, oseltamivir, and corticosteroids were used in 76%, 43%, and 23%, respectively, but not hydroxychloroquine. The median pediatric intensive care unit length-of-stay was five days; there were two deaths (3%) in the non- multisystemic inflammatory syndrome group. Patients with comorbidities were older and comorbidities were independently associated with the need for invasive mechanical ventilation (OR 5.5; 95% CI, 1.43--21.12; p = 0.01). Conclusions: In Brazilian pediatric intensive care units, COVID-19 had low mortality, age less than 1 year was not associated with a worse prognosis, and patients with multisystemic inflammatory syndrome had more severe symptoms, higher inflammatory biomarkers, and a greater predominance of males, but only comorbidities and chronic diseases were independent predictors of severity.
- Subjects
BRAZIL; COVID-19; INTENSIVE care units; COMORBIDITY; CORTICOSTEROIDS; ANTIBIOTICS
- Publication
Jornal de Pediatria, 2020, Vol 96, Issue 5, p582
- ISSN
0021-7557
- Publication type
Article
- DOI
10.1016/j.jpedp.2020.07.002