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Paediatric critical COVID-19 and mortality in a multinational prospective cohort.

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  • Additional Information
    • Corporate Authors:
    • Source:
      Publisher: Elsevier Ltd Country of Publication: England NLM ID: 9918232503006676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2667-193X (Electronic) Linking ISSN: 2667193X NLM ISO Abbreviation: Lancet Reg Health Am Subsets: PubMed not MEDLINE
    • Publication Information:
      Original Publication: [Oxford] : Elsevier Ltd., [2021]-
    • Abstract:
      Background: To understand critical paediatric coronavirus disease 2019 (COVID-19) and evaluate factors associated with mortality in children from high and low-middle income countries.
      Methods: Prospective, observational study of critically ill children hospitalised for COVID-19 in 18 countries throughout North America, Latin America, and Europe between April 1 and December 31, 2020. Associations with mortality were evaluated using logistic regression.
      Findings: 557 patients (median age, 8 years; 24% <2 years) were enrolled from 55 sites (63% Latin American). Half had comorbidities. Invasive (41%) or non-invasive (20%) ventilation and vasopressors (56%) were the most common support modalities. Hospital mortality was 10% and higher in children <2 years old (15%; odds ratio 1·94, 95%CI 1·08-3·49). Most who died had pulmonary disease. When adjusted for age, sex, region, and illness severity, mortality-associated factors included cardiac (aOR 2·89; 95%CI 1·2-6·94) or pulmonary comorbidities (aOR 4·43; 95%CI 1·70-11·5), admission hypoxemia (aOR 2·44; 95%CI 1·30-4·57), and lower respiratory symptoms (aOR 2·96; 95%CI 1·57-5·59). MIS-C (aOR 0·25; 95%CI 0·1-0·61) and receiving methylprednisolone (aOR 0·5; 95%CI 0·25-0·99), IVIG (aOR 0·32; 95%CI 0·16-0·62), or anticoagulation (aOR 0·49; 95%CI 0·25-0·95) were associated with lower mortality although these associations might be limited to children >2 years old.
      Interpretation: We identified factors associated with COVID-19 mortality in critically ill children from both high and low-middle income countries, including higher mortality with younger age and COVID-related pulmonary disease but lower mortality in MIS-C. Further research is needed on optimal treatments for younger children and respiratory failure in paediatric COVID-19.
      Funding: None.
      Competing Interests: No authors have any conflicts of interest to disclose
      (© 2022 The Author(s).)
    • References:
      Pediatr Crit Care Med. 2015 Jun;16(5 Suppl 1):S23-40. (PMID: 26035358)
      N Engl J Med. 2021 Feb 25;384(8):693-704. (PMID: 32678530)
      Pediatr Crit Care Med. 2021 Jul 1;22(7):603-615. (PMID: 33965987)
      Lancet Child Adolesc Health. 2021 Aug;5(8):559-568. (PMID: 34119027)
      N Engl J Med. 2021 Jul 1;385(1):11-22. (PMID: 34133854)
      J Pediatr (Rio J). 2020 Sep - Oct;96(5):582-592. (PMID: 32781034)
      BMJ. 2020 Aug 27;370:m3249. (PMID: 32960186)
      JAMA Pediatr. 2022 Mar 01;176(3):e216436. (PMID: 35044430)
      Crit Care. 2020 Nov 26;24(1):666. (PMID: 33243303)
      Arch Dis Child. 2020 Dec 1;:. (PMID: 33262177)
      Pediatr Crit Care Med. 2020 Sep;21(9):e643-e650. (PMID: 32649399)
      Pediatr Infect Dis J. 2020 Nov;39(11):e374-e376. (PMID: 32826724)
      Pediatr Infect Dis J. 2021 Apr 1;40(4):e137-e145. (PMID: 33538539)
      Pediatr Res. 2022 Jun;91(7):1730-1734. (PMID: 33941862)
      Lancet Infect Dis. 2021 Jun;21(6):758-759. (PMID: 33887207)
      PLoS One. 2021 Jan 29;16(1):e0246326. (PMID: 33513204)
      Crit Care Explor. 2021 Mar 15;3(3):e0362. (PMID: 33786438)
      Crit Care Med. 2013 Jul;41(7):1761-73. (PMID: 23685639)
      Crit Care Med. 1996 May;24(5):743-52. (PMID: 8706448)
      MMWR Morb Mortal Wkly Rep. 2020 Aug 14;69(32):1081-1088. (PMID: 32790664)
      Emerg Infect Dis. 2021 May;27(5):1457-1461. (PMID: 33760725)
      Lancet Child Adolesc Health. 2021 May;5(5):e12-e13. (PMID: 33713603)
      J Pediatr (Rio J). 2021 May-Jun;97(3):354-361. (PMID: 33186512)
      Pediatrics. 2020 Sep;146(3):. (PMID: 32518171)
      JAMA. 2021 Mar 2;325(9):855-864. (PMID: 33523115)
      Sci Transl Med. 2020 Oct 7;12(564):. (PMID: 32958614)
      Eur Rev Med Pharmacol Sci. 2021 Jan;25(2):1146-1157. (PMID: 33577071)
      JAMA. 2021 Mar 16;325(11):1074-1087. (PMID: 33625505)
      Pediatrics. 2021 Mar;147(3):. (PMID: 33323493)
      Crit Care Med. 2022 Jan 1;50(1):e40-e51. (PMID: 34387240)
      N Engl J Med. 2021 Jul 1;385(1):23-34. (PMID: 34133855)
      Pediatr Crit Care Med. 2021 May 1;22(5):e285-e293. (PMID: 33767074)
    • Contributed Indexing:
      Investigator: R Nofziger; S Ambati; T Kendirli; R Sanders; L Polikoff; S Whelan; A Camporesi; C Francoeur; F Castro; C Beltrán; R Pardo; G Vega; M Yunge; L Acevedo; IJ Ardila; D Aranguiz; S Dallefeld; M Alvarez-Olmos; J Fernandez-Sarmiento; A Figueroa-Vargas; M Valencia-Benavides; JD Roa; R Lasso-Palomino; A Franceschi; C Venthur; S Gonzalez-Dambrauskas; C Ampuero; JE Paco-Barral; J Tasayco-Muñoz; J Domínguez-Rojas; F Rafael-Patricio; S Pellegrini; M Zuazaga; S Brusca; M Viera; VI Aguilera-Avendano; F Alejandro; L Martínez; E Thelma; M Terán; M Coronado-Lujan; F Castro-Mancilla; F Diaz-Rubio; K Cinquegrana; A Sandoval; A Gonzalez; M Zamora; Y Lopez-Alarcon; M Slöcker-Barrio; J Urbano-Villaescusa; H Camacho; L Mazzillo; B Giraldo; P Suarez; M Cespedes-Lesczinsky; JO Castillo; JP Fabris; C Paladino; S Sanabria; E Urena-Chavarría; A Yock-Corrales; G Quispe; M Munaico-Abanto; M Colombo; AC Blanco; BE Pineres-Olave; R Carvajal-Veas; P Correa; R Garcia-De-Jesus; A Ferre; P Pietroboni; E Mauricio-Cantillano; L Banegas-Pineda; N Casson-Rodriguez; A Cavagnaro; A Wegner; E Zemanate; E Beltran-Zuñiga; MA Suarez; D Quiñonez; L Valero; A Repetur; P Castellani; A Bordogna; A De-la-Hoz-Pastor; E Obando-Belalcazar; A Prout; R Jabornisky; A Wen; B Coates; C Watson; E Mack; J Hong; T Karsies; S Pon; H Dapul; S Shein; M Kangin; P Vasquez-Hoyos; S Gertz; L Ducharme-Crevier; I Harwayne-Gidansky; M Fonseca-Flores; JC Nunez-Enriquez; A Leon-Villanueva; L Maria; T Muisyo; M Spaeder
      Keywords: COVID-19; Epidemiology; Mortality; Outcomes; Paediatric intensive care unit
    • Publication Date:
      Date Created: 20220523 Latest Revision: 20221011
    • Publication Date:
      20240105
    • Accession Number:
      PMC9111167
    • Accession Number:
      10.1016/j.lana.2022.100272
    • Accession Number:
      35599855