Preprint
Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study
Registro en:
PRATA-BARBOSA, Arnaldo et al. Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study. Jornal de Pediatria, p. 1-11, 2020.
0021-7557
10.1016/j.jped.2020.07.002
Autor
Prata-Barbosa, Arnaldo
Lima-Setta, Fernanda
Santos, Gustavo Rodrigues dos
Lanziotti, Vanessa Soares
Castro, Roberta Esteves Vieira de
Souza, Daniela Carla de
Raymundo, Carlos Eduardo
Oliveira, Felipe Rezende Caino de
Lima, Lucio Flavio Peixoto de
Tonial, Cristian Tedesco
Colleti, José
Bellinat, Ana Paula Novaes
Lorenzo, Vivian Botelho
Zeitel, Raquel de Seixas
Pulcheri, Lucas
Costa, Fernanda Ciuffo Monte da
La Torre, Fabíola Peixoto Ferreira
Figueiredo, Elaine Augusta das Neves
Silva, Thiago Peres da
Riveiro, Paula Marins
Mota, Isabele Coelho Fonseca da
Brandão, Igor Bromonschenkel
Azevedo, Zina Maria Almeida de
Gregory, Simone Camera
Boedo, Fernanda Raquel Oliveira
Carvalho, Rosana Novais de
Castro, Natália Almeida de Arnaldo Silva Rodriguez
Genu, Daniel Hilário Santos
Foronda, Flavia Andrea Krepel
Cunha, Antonio José Ledo A.
Magalhães-Barbosa, Maria Clara de
Resumen
Objective: To describe the clinical characteristics of children and adolescents admitted to intensive care with confirmed COVID-19. Method: Prospective, multicenter, observational study, in 19 pediatric intensive care units. Patients aged 1 month to 19 years admitted consecutively (March–May 2020) were included. Demographic, clinical-epidemiological features, treatment, and outcomes were collected. Subgroups were compared according to comorbidities, age < 1 year, and need for invasive mechanical ventilation. A multivariable logistic regression model was used for predictors of severity. Results: Seventy-nine patients were included (ten with multisystemic inflammatory syndrome). Median age 4 years; 54% male (multisystemic inflammatory syndrome, 80%); 41% had comorbidities (multisystemic inflammatory syndrome, 20%). Fever (76%), cough (51%), and tachypnea (50%) were common in both groups. Severe symptoms, gastrointestinal symptoms, and higher inflammatory markers were more frequent in multisystemic inflammatory syndrome. Interstitial lung infiltrates were common in both groups, but pleural effusion was more prevalent in the multisystemic inflammatory syndrome group (43% vs. 14%). Invasive mechanical ventilation was used in 18% (median 7.5 days); antibiotics, oseltamivir, and corticosteroids were used in 76%, 43%, and 23%, respectively, but not hydroxychloroquine. The median pediatric intensive care unit length-of-stay was five days; there were two deaths (3%) in the non- multisystemic inflammatory syndrome group. Patients with comorbidities were older, and comorbidities were independently associated with the need for invasive mechanical ventilation (OR 5.5; 95% CI, 1.43–21.12; p = 0.01). Conclusions: In Brazilian pediatric intensive care units, COVID-19 had low mortality, age less than 1 year was not associated with a worse prognosis, and patients with multisystemic inflammatory syndrome had more severe symptoms, higher inflammatory biomarkers, and a greater predominance of males, but only comorbidities and chronic diseases were independent predictors of severity.