Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experience
Objective: To describe the clinical characteristics, laboratory parameters, treatment, and predictors of an unfavorable outcome of critically ill children with SARS-CoV-2 infection. Method: This was a prospective observational study performed in a pediatric intensive care unit (PICU) of a tertiary c...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Jornal de Pediatria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755722000031 |
| _version_ | 1828217593723355136 |
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| author | Maha Ashraf Kazi Satyabrata Roychowdhury Sanajit Ghosh Manas Kumar Mahapatra Subhajit Bhakta Mithun Chandra Konar Mihir Sarkar |
| author_facet | Maha Ashraf Kazi Satyabrata Roychowdhury Sanajit Ghosh Manas Kumar Mahapatra Subhajit Bhakta Mithun Chandra Konar Mihir Sarkar |
| author_sort | Maha Ashraf Kazi |
| collection | DOAJ |
| description | Objective: To describe the clinical characteristics, laboratory parameters, treatment, and predictors of an unfavorable outcome of critically ill children with SARS-CoV-2 infection. Method: This was a prospective observational study performed in a pediatric intensive care unit (PICU) of a tertiary care COVID referral hospital among critically ill children in the age group 1 month - 12 years admitted due to SARS-CoV-2 infection from June to December 2020. Demographic, clinical profile, pSOFA and PRISM III scores, laboratory parameters, treatment, and outcomes of the patients were recorded. Children who had a prolonged PICU stay (>14 days) or died were compared with those who were discharged from PICU within 14 days to assess predictors of unfavorable outcomes. Results: PICU admission rate among hospitalized SARS-CoV-2 infected children was 22.1% (92/416). Infants comprised the majority of the ICU population. Invasive mechanical ventilation and inotropic support were required for 28.3% and 37% of patients, respectively. Remdesivir, IVIg, and steroids were administered to 15.2%, 26.1%, and 54.3% of the subjects, respectively. The mortality rate was 7.6 %. MIS-C patients were older, less comorbid, and required less ventilator support but more inotrope support than acute severe COVID-19 patients. Predictors of unfavorable outcomes were age < 1 year, fever duration > 5 days, respiratory distress, shock, comorbidity, elevated CRP (> 50 mg/L), procalcitonin (> 6 ng/L), D-dimer (> 6 µg/L) and arterial lactate (> 2 mmol/L). Conclusion: Critically ill children with unfavorable outcomes were predominantly infants, comorbid, prolonged fever, respiratory distress, shock and elevated inflammatory markers, D-dimer and lactate. These factors may be useful for watchful monitoring and early intervention. |
| first_indexed | 2024-04-12T15:50:08Z |
| format | Article |
| id | doaj.art-d3787ae4a6b9491fab6da1cd23183123 |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-12T15:50:08Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-d3787ae4a6b9491fab6da1cd231831232022-12-22T03:26:33ZengElsevierJornal de Pediatria0021-75572022-09-01985504512Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experienceMaha Ashraf Kazi0Satyabrata Roychowdhury1Sanajit Ghosh2Manas Kumar Mahapatra3Subhajit Bhakta4Mithun Chandra Konar5Mihir Sarkar6Department of Pediatrics, Medical College and Hospital, Kolkata, IndiaDepartment of Pediatrics, North Bengal Medical College and Hospital, Siliguri, IndiaDepartment of Pediatrics, Medical College and Hospital, Kolkata, IndiaDepartment of Pediatrics, Medical College and Hospital, Kolkata, IndiaPICU Unit, Department of Pediatrics, Medical College and Hospital, Kolkata, IndiaPICU Unit, Department of Pediatrics, Medical College and Hospital, Kolkata, IndiaPICU Unit, Department of Pediatrics, Medical College and Hospital, Kolkata, India; Corresponding author.Objective: To describe the clinical characteristics, laboratory parameters, treatment, and predictors of an unfavorable outcome of critically ill children with SARS-CoV-2 infection. Method: This was a prospective observational study performed in a pediatric intensive care unit (PICU) of a tertiary care COVID referral hospital among critically ill children in the age group 1 month - 12 years admitted due to SARS-CoV-2 infection from June to December 2020. Demographic, clinical profile, pSOFA and PRISM III scores, laboratory parameters, treatment, and outcomes of the patients were recorded. Children who had a prolonged PICU stay (>14 days) or died were compared with those who were discharged from PICU within 14 days to assess predictors of unfavorable outcomes. Results: PICU admission rate among hospitalized SARS-CoV-2 infected children was 22.1% (92/416). Infants comprised the majority of the ICU population. Invasive mechanical ventilation and inotropic support were required for 28.3% and 37% of patients, respectively. Remdesivir, IVIg, and steroids were administered to 15.2%, 26.1%, and 54.3% of the subjects, respectively. The mortality rate was 7.6 %. MIS-C patients were older, less comorbid, and required less ventilator support but more inotrope support than acute severe COVID-19 patients. Predictors of unfavorable outcomes were age < 1 year, fever duration > 5 days, respiratory distress, shock, comorbidity, elevated CRP (> 50 mg/L), procalcitonin (> 6 ng/L), D-dimer (> 6 µg/L) and arterial lactate (> 2 mmol/L). Conclusion: Critically ill children with unfavorable outcomes were predominantly infants, comorbid, prolonged fever, respiratory distress, shock and elevated inflammatory markers, D-dimer and lactate. These factors may be useful for watchful monitoring and early intervention.http://www.sciencedirect.com/science/article/pii/S0021755722000031Critically ill childrenCOVID-19PICUPredictors of unfavorable outcome |
| spellingShingle | Maha Ashraf Kazi Satyabrata Roychowdhury Sanajit Ghosh Manas Kumar Mahapatra Subhajit Bhakta Mithun Chandra Konar Mihir Sarkar Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experience Jornal de Pediatria Critically ill children COVID-19 PICU Predictors of unfavorable outcome |
| title | Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experience |
| title_full | Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experience |
| title_fullStr | Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experience |
| title_full_unstemmed | Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experience |
| title_short | Characteristics and predictors of outcomes of critically Ill children with SARS-CoV-2 infection - the PICU experience |
| title_sort | characteristics and predictors of outcomes of critically ill children with sars cov 2 infection the picu experience |
| topic | Critically ill children COVID-19 PICU Predictors of unfavorable outcome |
| url | http://www.sciencedirect.com/science/article/pii/S0021755722000031 |
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