tetano
Editor, Senior Moderator
PLoS One
. 2024 May 7;19(5):e0283037.
doi: 10.1371/journal.pone.0283037. eCollection 2024. Relationship between sociodemographic, clinical, and laboratory characteristics and severity of COVID-19 in pediatric patients
Cristian Roca[SUP] 1 [/SUP], Adriana Asturizaga[SUP] 2 [/SUP], Nelson Villca[SUP] 3 [/SUP], Ramiro Cabrera[SUP] 4 [/SUP], Raul Copana-Olmos[SUP] 5 6 [/SUP], Vladimir Aguilera-Avendano[SUP] 7 [/SUP], Claudia Estrada-Villarroel[SUP] 7 [/SUP], Mariel Andrea Forest-Yepez[SUP] 8 [/SUP], Marcia Torrez-Santos[SUP] 9 [/SUP], Adela Felipa Magne-Calle[SUP] 9 [/SUP], Maria Ofelia Foronda-Rios[SUP] 10 [/SUP], Liz Malena Pena-Helguero[SUP] 10 [/SUP], Monica Montalvo[SUP] 4 [/SUP], Delina Torrez[SUP] 11 [/SUP], Mirna Toco[SUP] 12 [/SUP], Miguel Cespedes[SUP] 13 [/SUP], Ingrid Davalos[SUP] 14 [/SUP], Natalie M Bowman[SUP] 15 [/SUP]; COVID19 Research Group in Bolivia
Affiliations
COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1-10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2-6.5), breathing difficulty OR: 3.4 (CI95%: 1.4-8.2), vomiting OR: 3.3 (CI95%: 1.4-7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9-16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.
. 2024 May 7;19(5):e0283037.
doi: 10.1371/journal.pone.0283037. eCollection 2024. Relationship between sociodemographic, clinical, and laboratory characteristics and severity of COVID-19 in pediatric patients
Cristian Roca[SUP] 1 [/SUP], Adriana Asturizaga[SUP] 2 [/SUP], Nelson Villca[SUP] 3 [/SUP], Ramiro Cabrera[SUP] 4 [/SUP], Raul Copana-Olmos[SUP] 5 6 [/SUP], Vladimir Aguilera-Avendano[SUP] 7 [/SUP], Claudia Estrada-Villarroel[SUP] 7 [/SUP], Mariel Andrea Forest-Yepez[SUP] 8 [/SUP], Marcia Torrez-Santos[SUP] 9 [/SUP], Adela Felipa Magne-Calle[SUP] 9 [/SUP], Maria Ofelia Foronda-Rios[SUP] 10 [/SUP], Liz Malena Pena-Helguero[SUP] 10 [/SUP], Monica Montalvo[SUP] 4 [/SUP], Delina Torrez[SUP] 11 [/SUP], Mirna Toco[SUP] 12 [/SUP], Miguel Cespedes[SUP] 13 [/SUP], Ingrid Davalos[SUP] 14 [/SUP], Natalie M Bowman[SUP] 15 [/SUP]; COVID19 Research Group in Bolivia
Affiliations
- PMID: 38713667
- PMCID: PMC11075884
- DOI: 10.1371/journal.pone.0283037
COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1-10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2-6.5), breathing difficulty OR: 3.4 (CI95%: 1.4-8.2), vomiting OR: 3.3 (CI95%: 1.4-7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9-16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.