tetano
Editor, Senior Moderator
J Pediatric Infect Dis Soc
. 2022 Jan 12;piab123.
doi: 10.1093/jpids/piab123. Online ahead of print.
A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020
Jennifer E Schuster[SUP] 1 [/SUP], Natasha B Halasa[SUP] 2 [/SUP], Mari Nakamura[SUP] 3 4 [/SUP], Emily R Levy[SUP] 5 [/SUP], Julie C Fitzgerald[SUP] 6 [/SUP], Cameron C Young[SUP] 7 [/SUP], Margaret M Newhams[SUP] 7 [/SUP], Florence Bourgeois[SUP] 8 [/SUP], Mary A Staat[SUP] 9 [/SUP], Charlotte V Hobbs[SUP] 10 [/SUP], Heda Dapul[SUP] 11 [/SUP], Leora R Feldstein[SUP] 12 [/SUP], Ashley M Jackson[SUP] 12 [/SUP], Elizabeth H Mack[SUP] 13 [/SUP], Tracie C Walker[SUP] 14 [/SUP], Aline B Maddux[SUP] 15 [/SUP], Philip C Spinella[SUP] 16 [/SUP], Laura L Loftis[SUP] 17 [/SUP], Michele Kong[SUP] 18 [/SUP], Courtney M Rowan[SUP] 19 [/SUP], Melania M Bembea[SUP] 20 [/SUP], Gwenn E McLaughlin[SUP] 21 [/SUP], Mark W Hall[SUP] 22 [/SUP], Christopher J Babbitt[SUP] 23 [/SUP], Mia Maamari[SUP] 24 [/SUP], Matt S Zinter[SUP] 25 [/SUP], Natalie Z Cvijanovich[SUP] 26 [/SUP], Kelly N Michelson[SUP] 27 [/SUP], Shira J Gertz[SUP] 28 [/SUP], Christopher L Carroll[SUP] 29 [/SUP], Neal J Thomas[SUP] 30 [/SUP], John S Giuliano[SUP] 31 [/SUP], Aalok R Singh[SUP] 32 [/SUP], Saul R Hymes[SUP] 33 [/SUP], Adam J Schwarz[SUP] 34 [/SUP], John K McGuire[SUP] 35 [/SUP], Ryan A Nofziger[SUP] 36 [/SUP], Heidi R Flori[SUP] 37 [/SUP], Katharine N Clouser[SUP] 38 [/SUP], Kari Wellnitz[SUP] 39 [/SUP], Melissa L Cullimore[SUP] 40 [/SUP], Janet R Hume[SUP] 41 [/SUP], Manish Patel[SUP] 12 [/SUP], Adrienne G Randolph[SUP] 7 42 [/SUP], Overcoming COVID-19 Investigators
Affiliations
Abstract
Background: It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered.
Methods: Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated.
Results: Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI: 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI: 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December).
Conclusion: Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies.
Keywords: COVID-19; intensive care unit; pediatric; remdesivir; treatment.
. 2022 Jan 12;piab123.
doi: 10.1093/jpids/piab123. Online ahead of print.
A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020
Jennifer E Schuster[SUP] 1 [/SUP], Natasha B Halasa[SUP] 2 [/SUP], Mari Nakamura[SUP] 3 4 [/SUP], Emily R Levy[SUP] 5 [/SUP], Julie C Fitzgerald[SUP] 6 [/SUP], Cameron C Young[SUP] 7 [/SUP], Margaret M Newhams[SUP] 7 [/SUP], Florence Bourgeois[SUP] 8 [/SUP], Mary A Staat[SUP] 9 [/SUP], Charlotte V Hobbs[SUP] 10 [/SUP], Heda Dapul[SUP] 11 [/SUP], Leora R Feldstein[SUP] 12 [/SUP], Ashley M Jackson[SUP] 12 [/SUP], Elizabeth H Mack[SUP] 13 [/SUP], Tracie C Walker[SUP] 14 [/SUP], Aline B Maddux[SUP] 15 [/SUP], Philip C Spinella[SUP] 16 [/SUP], Laura L Loftis[SUP] 17 [/SUP], Michele Kong[SUP] 18 [/SUP], Courtney M Rowan[SUP] 19 [/SUP], Melania M Bembea[SUP] 20 [/SUP], Gwenn E McLaughlin[SUP] 21 [/SUP], Mark W Hall[SUP] 22 [/SUP], Christopher J Babbitt[SUP] 23 [/SUP], Mia Maamari[SUP] 24 [/SUP], Matt S Zinter[SUP] 25 [/SUP], Natalie Z Cvijanovich[SUP] 26 [/SUP], Kelly N Michelson[SUP] 27 [/SUP], Shira J Gertz[SUP] 28 [/SUP], Christopher L Carroll[SUP] 29 [/SUP], Neal J Thomas[SUP] 30 [/SUP], John S Giuliano[SUP] 31 [/SUP], Aalok R Singh[SUP] 32 [/SUP], Saul R Hymes[SUP] 33 [/SUP], Adam J Schwarz[SUP] 34 [/SUP], John K McGuire[SUP] 35 [/SUP], Ryan A Nofziger[SUP] 36 [/SUP], Heidi R Flori[SUP] 37 [/SUP], Katharine N Clouser[SUP] 38 [/SUP], Kari Wellnitz[SUP] 39 [/SUP], Melissa L Cullimore[SUP] 40 [/SUP], Janet R Hume[SUP] 41 [/SUP], Manish Patel[SUP] 12 [/SUP], Adrienne G Randolph[SUP] 7 42 [/SUP], Overcoming COVID-19 Investigators
Affiliations
- PMID: 35022779
- DOI: 10.1093/jpids/piab123
Abstract
Background: It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered.
Methods: Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated.
Results: Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI: 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI: 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December).
Conclusion: Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies.
Keywords: COVID-19; intensive care unit; pediatric; remdesivir; treatment.