Cardiovascular sequelae from COVID-19: perspectives from a paediatric cardiac ICU

被引:1
作者
Lasa, Javier J. [1 ,2 ]
Alali, Alexander [2 ]
Anders, Marc [1 ,2 ]
Tume, Sebastian C. [1 ,2 ]
Muscal, Eyal [3 ]
Tejtel, S. Kristen Sexson [2 ]
Shekerdemian, Lara [1 ,2 ]
机构
[1] Baylor Coll Med, Texas Childrens Hosp, Div Crit Care Med, MC E1420,6651 Main St, Houston, TX 77030 USA
[2] Baylor Coll Med, Texas Childrens Hosp, Div Cardiol, MC E1420,6651 Main St, Houston, TX 77030 USA
[3] Baylor Coll Med, Texas Childrens Hosp, Div Rheumatol, Houston, TX 77030 USA
关键词
COVID-19; MIS-C; paediatric; intensive care; cardiac ICU; DISEASE;
D O I
10.1017/S1047951122000130
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Paediatric ICUs have shared the burden of the COVID-19 pandemic, including subspecialty cardiac ICUs. We sought to address knowledge gaps regarding patient characteristics, acuity, and sequelae of COVID-19 in the paediatric cardiac ICU setting. Design: Retrospective review of paediatric cardiac ICU admissions with COVID-19-related disease. Setting: Single centre tertiary care paediatric cardiac ICU. Patients: All patients with PCR/antibody evidence of primary COVID-19 infection, and/or Multisystem Inflammatory Syndrome in Children, were admitted between 26 March, 2020 and 31 March, 2021. Interventions: None. Main outcomes measures: Patient-level demographics, pre-existing conditions, clinical symptoms, and outcomes related to ICU admission were captured from medical records. Results: Among 1064 patients hospitalised with COVID-19/Multisystem Inflammatory Syndrome in Children, 102 patients (9.5%) were admitted to cardiac ICU, 76 of which were symptomatic (median age 12.5 years [IQR 7.5-16.0]). The primary system involved at presentation was cardiovascular in 48 (63%). Vasoactive infusions were required in 62% (n = 47), with eight patients (11%) requiring VA ECMO. Severity of disease was categorised as mild/moderate in 16 (21%) and severe/critical in 60 patients (79%). On univariate analysis, African-American race, presentation with gastrointestinal symptoms or elevated inflammatory markers were associated with risk for severe disease. All-cause death was observed in five patients (7%, n = 5/72) with four patients remaining hospitalised at the time of data query. Conclusion: COVID-19 and its cardiovascular sequelae were associated with important morbidity and significant mortality in a notable minority of paediatric patients admitted to a paediatric cardiac ICU. Further study is required to quantify the risk of morbidity and mortality for COVID-19 and sequelae.
引用
收藏
页码:52 / 59
页数:8
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