tetano
Editor, Senior Moderator
Pediatr Pulmonol
. 2023 Jul 26.
doi: 10.1002/ppul.26613. Online ahead of print. Characteristics and management of patients with SARS-CoV2 infection admitted to pediatric intensive care units: Data analysis of the Spanish national multicenter registry
María Slöcker Barrio[SUP] 1 2 3 [/SUP], Sylvia Belda Hofheinz[SUP] 3 4 [/SUP], Carmina Guitart Pardellans[SUP] 5 [/SUP], Alberto García-Salido[SUP] 6 [/SUP], Juan Carlos de Carlos Vicente[SUP] 7 [/SUP], Maite Cuervas-Mons Tejedor[SUP] 8 [/SUP], Alexandra Hernández Yuste[SUP] 9 [/SUP], Ainhoa Jiménez Olmos[SUP] 10 [/SUP], Elvira Morteruel Arizcuren[SUP] 11 [/SUP], Maria García-Besteiro[SUP] 12 [/SUP], Cristina Calvo Monge[SUP] 13 [/SUP], Miguel Rodríguez Rubio[SUP] 14 [/SUP], David Roca Pascual[SUP] 15 [/SUP], Lorena Bermúdez Barrezueta[SUP] 16 [/SUP], Carmen Martínez Padilla[SUP] 17 [/SUP], Beatriz Huidobro Labarga[SUP] 18 [/SUP], Ignacio Oulego-Erroz[SUP] 19 [/SUP], Sonia Sanchíz Cárdenas[SUP] 20 [/SUP], Corsino Rey Galan[SUP] 21 [/SUP], Maria Soledad Holanda Peña[SUP] 22 [/SUP], Pablo González Navarro[SUP] 23 [/SUP], Rafael González Cortés[SUP] 1 2 3 [/SUP]; Spanish Pediatric Intensive Care Society working group on SARS-Cov2 infection
Affiliations
Introduction: The 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).
Methods: The 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).
Results: A 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).
Conclusions: Severe 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.
Keywords: ARDS; MIS-C; SARS-COV2; mechanical ventilation; pediatric intensive care.
. 2023 Jul 26.
doi: 10.1002/ppul.26613. Online ahead of print. Characteristics and management of patients with SARS-CoV2 infection admitted to pediatric intensive care units: Data analysis of the Spanish national multicenter registry
María Slöcker Barrio[SUP] 1 2 3 [/SUP], Sylvia Belda Hofheinz[SUP] 3 4 [/SUP], Carmina Guitart Pardellans[SUP] 5 [/SUP], Alberto García-Salido[SUP] 6 [/SUP], Juan Carlos de Carlos Vicente[SUP] 7 [/SUP], Maite Cuervas-Mons Tejedor[SUP] 8 [/SUP], Alexandra Hernández Yuste[SUP] 9 [/SUP], Ainhoa Jiménez Olmos[SUP] 10 [/SUP], Elvira Morteruel Arizcuren[SUP] 11 [/SUP], Maria García-Besteiro[SUP] 12 [/SUP], Cristina Calvo Monge[SUP] 13 [/SUP], Miguel Rodríguez Rubio[SUP] 14 [/SUP], David Roca Pascual[SUP] 15 [/SUP], Lorena Bermúdez Barrezueta[SUP] 16 [/SUP], Carmen Martínez Padilla[SUP] 17 [/SUP], Beatriz Huidobro Labarga[SUP] 18 [/SUP], Ignacio Oulego-Erroz[SUP] 19 [/SUP], Sonia Sanchíz Cárdenas[SUP] 20 [/SUP], Corsino Rey Galan[SUP] 21 [/SUP], Maria Soledad Holanda Peña[SUP] 22 [/SUP], Pablo González Navarro[SUP] 23 [/SUP], Rafael González Cortés[SUP] 1 2 3 [/SUP]; Spanish Pediatric Intensive Care Society working group on SARS-Cov2 infection
Affiliations
- PMID: 37493137
- DOI: 10.1002/ppul.26613
Introduction: The 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).
Methods: The 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).
Results: A 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).
Conclusions: Severe 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.
Keywords: ARDS; MIS-C; SARS-COV2; mechanical ventilation; pediatric intensive care.