tetano
Editor, Senior Moderator
Crit Care Sci
. 2024 Jul 19:36:e20240068en.
doi: 10.62675/2965-2774.20240068-en. eCollection 2024. Analysis of factors associated with admission to the intensive care unit of children and adolescents with COVID-19: application of a multilevel model
[Article in English, Portuguese]
Lecidamia Cristina Leite Damascena[SUP] 1 [/SUP], Aline Roseane Queiroz de Paiva Faria[SUP] 1 [/SUP], Nyellisonn Nando Nóbrega de Lucena[SUP] 1 [/SUP], Ana Hermínia Andrade E Silva[SUP] 1 [/SUP], Talita Tavares Alves de Almeida[SUP] 2 [/SUP], Diana de Fátima Alves Pinto[SUP] 2 [/SUP], Hemílio Fernandes Campos Coêlho[SUP] 1 [/SUP], Ana Maria Gondim Valença[SUP] 1 [/SUP]
Affiliations
Objective: To identify factors associated with hospitalization in the intensive care unit in children and adolescents with COVID-19.
Methods: This was a retrospective cohort study using secondary data of hospitalized children and adolescents (zero to 18 years old) with COVID-19 reported in Paraíba from April 2020 to July 2021, totaling 486 records. Descriptive analysis, logistic regression and multilevel regression were performed, utilizing a significance level of 5%.
Results: According to logistic regression without hierarchical levels, there was an increased chance of admission to the intensive care unit for male patients (OR = 1.98; 95%CI 1.18 - 3.32), patients with respiratory distress (OR = 2.43; 95%CI 1.29 - 4.56), patients with dyspnea (OR = 3.57; 95%CI 1.77 - 7.18) and patients living in large cities (OR = 2.70; 95%CI 1.07 - 6.77). The likelihood of requiring intensive care was observed to decrease with increasing age (OR = 0.94; 95%CI = 0.90 - 0.97), the presence of cough (OR = 0.32; 95%CI 0.18 - 0.59) or fever (OR = 0.42; 95%CI 0.23 - 0.74) and increasing Gini index (OR = 0.003; 95%CI 0.000 - 0.243). According to the multilevel analysis, the odds of admission to the intensive care unit increased in male patients (OR = 1.70; 95%CI = 1.68-1.71) and with increasing population size of the municipality per 100,000 inhabitants (OR = 1.01; 95%CI 1.01-1.03); additionally, the odds of admission to the intensive care unit decreased for mixed-race versus non-brown-skinned patients (OR = 0.981; 95%CI 0.97 - 0.99) and increasing Gini index (OR = 0.02; 95%CI 0.02 - 0.02).
Conclusion: The effects of patient characteristics and social context on the need for intensive care in children and adolescents with SARS-CoV-2 infection were better estimated with the inclusion of a multilevel regression model.
. 2024 Jul 19:36:e20240068en.
doi: 10.62675/2965-2774.20240068-en. eCollection 2024. Analysis of factors associated with admission to the intensive care unit of children and adolescents with COVID-19: application of a multilevel model
[Article in English, Portuguese]
Lecidamia Cristina Leite Damascena[SUP] 1 [/SUP], Aline Roseane Queiroz de Paiva Faria[SUP] 1 [/SUP], Nyellisonn Nando Nóbrega de Lucena[SUP] 1 [/SUP], Ana Hermínia Andrade E Silva[SUP] 1 [/SUP], Talita Tavares Alves de Almeida[SUP] 2 [/SUP], Diana de Fátima Alves Pinto[SUP] 2 [/SUP], Hemílio Fernandes Campos Coêlho[SUP] 1 [/SUP], Ana Maria Gondim Valença[SUP] 1 [/SUP]
Affiliations
- PMID: 39046060
- DOI: 10.62675/2965-2774.20240068-en
Objective: To identify factors associated with hospitalization in the intensive care unit in children and adolescents with COVID-19.
Methods: This was a retrospective cohort study using secondary data of hospitalized children and adolescents (zero to 18 years old) with COVID-19 reported in Paraíba from April 2020 to July 2021, totaling 486 records. Descriptive analysis, logistic regression and multilevel regression were performed, utilizing a significance level of 5%.
Results: According to logistic regression without hierarchical levels, there was an increased chance of admission to the intensive care unit for male patients (OR = 1.98; 95%CI 1.18 - 3.32), patients with respiratory distress (OR = 2.43; 95%CI 1.29 - 4.56), patients with dyspnea (OR = 3.57; 95%CI 1.77 - 7.18) and patients living in large cities (OR = 2.70; 95%CI 1.07 - 6.77). The likelihood of requiring intensive care was observed to decrease with increasing age (OR = 0.94; 95%CI = 0.90 - 0.97), the presence of cough (OR = 0.32; 95%CI 0.18 - 0.59) or fever (OR = 0.42; 95%CI 0.23 - 0.74) and increasing Gini index (OR = 0.003; 95%CI 0.000 - 0.243). According to the multilevel analysis, the odds of admission to the intensive care unit increased in male patients (OR = 1.70; 95%CI = 1.68-1.71) and with increasing population size of the municipality per 100,000 inhabitants (OR = 1.01; 95%CI 1.01-1.03); additionally, the odds of admission to the intensive care unit decreased for mixed-race versus non-brown-skinned patients (OR = 0.981; 95%CI 0.97 - 0.99) and increasing Gini index (OR = 0.02; 95%CI 0.02 - 0.02).
Conclusion: The effects of patient characteristics and social context on the need for intensive care in children and adolescents with SARS-CoV-2 infection were better estimated with the inclusion of a multilevel regression model.