Clinical Characteristics and Laboratory Abnormalities of Hospitalized and Critically Ill Children with Coronavirus Disease 2019: A Retrospective Study from Saudi Arabia (original) (raw)
Related papers
Background: The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with SARS-CoV-2.Methods: 325 COVID-19 pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files. Results: Of 325 patients, 189 (58%) and 136 (42%) were males and females, respectively. The mean age was 6.18 ± 4.99. 195 (60%) and 130 (40%), had moderate and severe conditions, respectively. 45 (13.9%) of patients died. The common symptoms were fever (72.6%), cough (59%) and shortness of breath (36%). 254 (78%) and 145 (44.6%( had gastrointestinal and neurological symptoms, respectively. Shortness of breath, rhinorrhea, nausea/vomiting, decrease in platelet counts; increase values in C-reactive protein, lactate dehydrogenase (LDH), and blood urea nitrogen, decrease in the blood PH and HC...
2021
Background: To date, less is known about the clinical features of COVID-19 pediatric patients admitting to ICUs. Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes between COVID-19 pediatric patients admitting to ICU and non-ICU settings.Methods: This multicenter study involved 15 general and pediatrics hospitals on confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive real-time reverse transcription polymerase chain reaction (RT-PCR) between March 19 and May 31, 2020, during the initial peak of the COVID-19 pandemic in Iran.Results: Overall, 166 patients were included, of which 61 (36.7%) required ICU admission, especially in <5 years old age group. Malignancy and heart diseases were the most frequent underlying condition. There was significant decrease in platelet counts, PH, HCO3 and base excess as well as increases in creatinine, creatine phosphokinase an...
Indian Journal of Critical Care Medicine
Background: Acute respiratory distress syndrome (ARDS) associated with COVID-19 in children is not well described in the literature, so this study was design to assess the severity, clinical course, different treatment measures, and outcome of this group of patients. Patients and methods: This descriptive study was performed by retrospective chart review of children admitted in pediatric intensive care unit (PICU) in the age-group of 1 month to 12 years over the period of 6 months (July-December 2020) in a tertiary care pediatric COVID facility in eastern India. Severity of ARDS, ventilator settings, oxygenation and laboratory parameters, and outcomes were documented. Predictors associated with severe ARDS were evaluated. Results: Among 128 laboratory-confirmed pediatric COVID-19 cases admitted in PICU, 18 (14%) developed ARDS, 6 (33.3%) had severe ARDS, and 3 (16.6%) succumbed to death. Outcome was measured by median hospital stay [20 days (IQR 19, 21)], PICU stay [13 days (IQR 10, 16)], and 28-day ventilator-free days [14 days (IQR 13, 22)]. Half (n = 9) of our study cohort had different comorbidities and congenital heart disease being the most common (4, 22.2%). Median positive end-expiratory pressure requirement was 10 cm H 2 O (9, 11) for invasively ventilated children (n = 13, 72.2%) along with peak inspiratory pressure of 24 cm H 2 O (20, 29) and mean airway pressure of 17 cm H 2 O (14, 20). Median oxygenation index was 13.3 (10.5, 18.6). Nine (69.2%) out of 13 intubated children had undergone prone ventilation. C-reactive protein (CRP) and D-dimer levels were significantly high in children with severe ARDS alongside pSOFA and lung USG score. Conclusion: Incidence of ARDS in pediatric COVID-19 though less but are not rare. Elevated CRP, D-dimer values, and high lung USG scores were associated with severe ARDS. Those who died had significant comorbidity.
Acta medica Philippina, 2021
Background. Coronavirus Disease 2019 (COVID-19) presents with respiratory signs and symptoms in children. Presently, there are no local studies on the pulmonary manifestations and management of COVID-19 among children. Objective. Our study aimed to identify and describe the presenting respiratory signs and symptoms, oxygenation status, radiologic findings, blood gas analysis, and pulmonary interventions among children admitted for COVID-19. We also analyzed the clinical and radiologic variables associated with mortality. Methodology. This is a retrospective study using data obtained from a review of medical records from April 1, 2020, to June 30, 2020, at a tertiary government institution in the Philippines. All pediatric patients (0-18 years) hospitalized for probable or confirmed COVID-19 during the said time period were included in this study. Univariate and multivariate logistic regression was applied to determine factors affecting mortality. Results. A total of 25 pediatric patients with a mean age of 7 years old (age range: 11 days to 18 years) were admitted for COVID-19. Cough (44%) and dyspnea (24%) were the most common presenting respiratory symptoms, while tachypnea (68%), crackles (36%), and peripheral oxygen desaturation (36%) were the most common respiratory signs. Indeterminate findings for COVID-19 such as multifocal or diffuse ground-glass opacities and/or consolidations were the most common radiographic abnormalities. Invasive ventilatory support was administered to 6 cases of severe COVID-19 and 4 critical cases. There were no variables that correlated significantly with mortality. Conclusion. Respiratory signs and symptoms were prominent in our cohort of children admitted due to COVID-19. Mechanical ventilation was required in more severe cases. Larger prospective studies may help identify variables that significantly correlate with poor outcomes among children with COVID-19.
Journal of Infection and Public Health, 2021
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Italian Journal of Pediatrics
Background Although with exceptions, evidence seems to indicate that children have lower susceptibility than adults to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. When infected, children generally remain asymptomatic or develop mild disease. A small number of pediatric cases required admission to the pediatric intensive care unit (PICU), respiratory support with a mechanical ventilation and additional life-saving interventions. Even if rarely, death can occur. Aim of this manuscript is to highlight the risk factors associated with severe outcome among pediatric patients with COVID-19. Main findings Early identification of SARS-CoV-2-infected children at risk of developing severe COVID-19 is vital for service planning, as severely affected pediatric patients require high-quality care and should be followed only where an adequately structured PICU is available. However, early identification of children who must be carefully monitored for substantial risk of...
Paediatric critical COVID-19: clinical features and outcomes during five waves
F1000Research
Background: Data reported from several countries show that both children and adolescents accounted for less than 2% of symptomatic cases of Coronavirus disease 2019 (COVID-19). The study objective was to describe the clinical characteristics of children admitted to Tunisian paediatric intensive care units (PICU). Methods: This was a single centre observational retrospective study conducted in the PICU of the Farhat Hached tertiary teaching hospital in Sousse, Tunisia during the period from the March 1, 2020 to February 28, 2022. We included all children aged from one month to 15 years with recent severe or critical severe acute respiratory syndrome coronavirus 2. Infection was confirmed by the positivity of reverse transcriptase either for SARS-CoV2 or with presence of IgM antibodies. We included severe and critical forms of COVID-19 according to the World Health Organization (WHO) classification. Results: 26 patients were included. 16 (61%) were one year old or younger. 18 patients...
Pediatric Critical Care Medicine, 2020
Objectives:In children, coronavirus disease 2019 is usually mild but can develop severe hypoxemic failure or a severe multisystem inflammatory syndrome, the latter considered to be a postinfectious syndrome, with cardiac involvement alone or together with a toxic shock like-presentation. Given the novelty of severe acute respiratory syndrome coronavirus 2, the causative agent of the recent coronavirus disease 2019 pandemic, little is known about the pathophysiology and phenotypic expressions of this new infectious disease nor the optimal treatment approach.Study Selection:From inception to July 10, 2020, repeated PubMed and open Web searches have been done by the scientific section collaborative group members of the European Society of Pediatric and Neonatal Intensive Care.Data Extraction:There is little in the way of clinical research in children affected by coronavirus disease 2019, apart from descriptive data and epidemiology.Data Synthesis:Even though basic treatment and organ s...
Clinical Picture and Risk Factors of Severe Respiratory Symptoms in COVID-19 in Children
Viruses
Children with COVID-19 develop moderate symptoms in most cases. Thus, a proportion of children requires hospital admission. The study aimed to assess the history, clinical and laboratory parameters in children with COVID-19 concerning the severity of respiratory symptoms. The study included 332 children (median age 57 months) with COVID-19. History data, clinical findings, laboratory parameters, treatment, and outcome, were evaluated. Children were compared in the groups that varied in the severity of symptoms of respiratory tract involvement. Children who required oxygen therapy represented 8.73%, and intensive care 1.5% of the whole cohort. Comorbidities were present in 126 patients (37.95%). Factors increasing the risk of oxygen therapy included comorbidities (odds ratio (OR) = 92.39; 95% confidence interval (95% CI) = (4.19; 2036.90); p < 0.00001), dyspnea (OR = 45.81; 95% CI (4.05; 518.21); p < 0.00001), auscultation abnormalities (OR = 34.33; 95% CI (2.59; 454.64); p <...
JAMA Pediatrics
; for the Columbia Pediatric COVID-19 Management Group IMPORTANCE Descriptions of the coronavirus disease 2019 (COVID-19) experience in pediatrics will help inform clinical practices and infection prevention and control for pediatric facilities. OBJECTIVE To describe the epidemiology, clinical, and laboratory features of patients with COVID-19 hospitalized at a children's hospital and to compare these parameters between patients hospitalized with and without severe disease. DESIGN, SETTING, AND PARTICIPANTS This retrospective review of electronic medical records from a tertiary care academically affiliated children's hospital in New York City, New York, included hospitalized children and adolescents (Յ21 years) who were tested based on suspicion for COVID-19 between March 1 to April 15, 2020, and had positive results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). EXPOSURES Detection of SARS-CoV-2 from a nasopharyngeal specimen using a reverse transcription-polymerase chain reaction assay. MAIN OUTCOMES AND MEASURES Severe disease as defined by the requirement for mechanical ventilation. RESULTS Among 50 patients, 27 (54%) were boys and 25 (50%) were Hispanic. The median days from onset of symptoms to admission was 2 days (interquartile range, 1-5 days). Most patients (40 [80%]) had fever or respiratory symptoms (32 [64%]), but 3 patients (6%) with only gastrointestinal tract presentations were identified. Obesity (11 [22%]) was the most prevalent comorbidity. Respiratory support was required for 16 patients (32%), including 9 patients (18%) who required mechanical ventilation. One patient (2%) died. None of 14 infants and 1 of 8 immunocompromised patients had severe disease. Obesity was significantly associated with mechanical ventilation in children 2 years or older (6 of 9 [67%] vs 5 of 25 [20%]; P = .03). Lymphopenia was commonly observed at admission (36 [72%]) but did not differ significantly between those with and without severe disease. Those with severe disease had significantly higher C-reactive protein (median, 8.978 mg/dL [to convert to milligrams per liter, multiply by 10] vs 0.64 mg/dL) and procalcitonin levels (median, 0.31 ng/mL vs 0.17 ng/mL) at admission (P< .001), as well as elevated peak interleukin 6, ferritin, and D-dimer levels during hospitalization. Hydroxychloroquine was administered to 15 patients (30%) but could not be completed for 3. Prolonged test positivity (maximum of 27 days) was observed in 4 patients (8%). CONCLUSIONS AND RELEVANCE In this case series study of children and adolescents hospitalized with COVID-19, the disease had diverse manifestations. Infants and immunocompromised patients were not at increased risk of severe disease. Obesity was significantly associated with disease severity. Elevated inflammatory markers were seen in those with severe disease.