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- Title
Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting.
- Authors
de Farias, Emmerson C. F.; Pavão Junior, Manoel J. C.; de Sales, Susan C. D.; do Nascimento, Luciana M. P. P.; Pavão, Dalila C. A.; Pinheiro, Anna P. S.; Pinheiro, Andreza H. O.; Alves, Marília C. B.; Ferraro, Kíssila M. M. M.; Aires, Larisse F. Q.; Dias, Luana G.; Machado, Mayara M. M.; Serrão, Michaelle J. D.; Gomes, Raphaella R.; de Moraes, Sara M. P.; Moura, Gabriella M. G.; de Sousa, Adriana M. B.; Pontes, Gabriela C. L.; Carvalho, Railana D. F. P.; Silva, Cristiane T. C.
- Abstract
SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo–18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2–28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3–202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4–13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization.
- Subjects
MULTISYSTEM inflammatory syndrome; CHILD mortality; CRITICALLY ill children; ADULT respiratory distress syndrome; DISEASE risk factors
- Publication
Scientific Reports, 2024, Vol 14, Issue 1, p1
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-024-55065-x