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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 1 2 3 , Sylvia Belda Hofheinz 3 4 , Carmina Guitart Pardellans 5 , Alberto García-Salido 6 , Juan Carlos de Carlos Vicente 7 , Maite Cuervas-Mons Tejedor 8 , Alexandra Hernández Yuste 9 , Ainhoa Jiménez Olmos 10 , Elvira Morteruel Arizcuren 11 , Maria García-Besteiro 12 , Cristina Calvo Monge 13 , Miguel Rodríguez Rubio 14 , David Roca Pascual 15 , Lorena Bermúdez Barrezueta 16 , Carmen Martínez Padilla 17 , Beatriz Huidobro Labarga 18 , Ignacio Oulego-Erroz 19 , Sonia Sanchíz Cárdenas 20 , Corsino Rey Galan 21 , Maria Soledad Holanda Peña 22 , Pablo González Navarro 23 , Rafael González Cortés 1 2 3 ; 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 1 2 3 , Sylvia Belda Hofheinz 3 4 , Carmina Guitart Pardellans 5 , Alberto García-Salido 6 , Juan Carlos de Carlos Vicente 7 , Maite Cuervas-Mons Tejedor 8 , Alexandra Hernández Yuste 9 , Ainhoa Jiménez Olmos 10 , Elvira Morteruel Arizcuren 11 , Maria García-Besteiro 12 , Cristina Calvo Monge 13 , Miguel Rodríguez Rubio 14 , David Roca Pascual 15 , Lorena Bermúdez Barrezueta 16 , Carmen Martínez Padilla 17 , Beatriz Huidobro Labarga 18 , Ignacio Oulego-Erroz 19 , Sonia Sanchíz Cárdenas 20 , Corsino Rey Galan 21 , Maria Soledad Holanda Peña 22 , Pablo González Navarro 23 , Rafael González Cortés 1 2 3 ; 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.