Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study

被引：46

作者：

Prata-Barbosa, Arnaldo ^{[1
,26
]}

Lima-Setta, Fernanda ^{[1
,26
]}

dos Santos, Gustavo Rodrigues ^{[1
,26
]}

Lanziotti, Vanessa Soares ^{[2
,26
]}

Vieira de Castro, Roberta Esteves ^{[3
,26
]}

de Souza, Daniela Carla ^{[4
,26
]}

Raymundo, Carlos Eduardo ^{[1
,26
]}

Caino de Oliveira, Felipe Rezende ^{[5
,26
]}

Peixoto de Lima, Lucio Flavio ^{[6
,26
]}

Tonial, Cristian Tedesco ^{[7
,26
]}

Colleti Jr, Jose ^{[8
,26
]}

Novaes Bellinat, Ana Paula ^{[9
,26
]}

Lorenzo, Vivian Botelho ^{[10
,26
]}

Zeitel, Raquel de Seixas ^{[11
,26
]}

Pulcheri, Lucas ^{[12
,26
]}

Monte da Costa, Fernanda Ciuffo ^{[13
,26
]}

Ferreira La Torre, Fabiola Peixoto ^{[14
,26
]}

das Neves Figueiredo, Elaine Augusta ^{[15
,26
]}

da Silva, Thiago Peres ^{[16
,26
]}

Riveiro, Paula Marins ^{[17
,26
]}

Fonseca da Mota, Isabele Coelho ^{[18
,26
]}

Brandao, Igor Bromonschenkel ^{[19
,26
]}

Almeida de Azevedo, Zina Maria ^{[20
,26
]}

Gregory, Simone Camera ^{[21
,26
]}

Oliveira Boedo, Fernanda Raquel ^{[22
,26
]}

de Carvalho, Rosana Novais ^{[23
,26
]}

de Arnaldo Silva Rodriguez Castro, Natalia Almeida ^{[24
,26
]}

Santos Genu, Daniel Hilario ^{[25
,26
]}

Krepel Foronda, Flavia Andrea ^{[4
,26
]}

Cunha, Antonio Jose Ledo A. ^{[2
,26
]}

de Magalhaes-Barbosa, Maria Clara ^{[1
,26
]}

机构：

[1] Inst DOr Pesquisa & Ensino IDOR, Rio De Janeiro, RJ, Brazil

[2] Univ Fed Rio de Janeiro, Rio De Janeiro, RJ, Brazil

[3] Univ Estado Rio de Janeiro, Rio De Janeiro, RJ, Brazil

[4] Hosp Sirio Libanes, Sao Paulo, SP, Brazil

[5] Hosp Alvorada Moema, Sao Paulo, SP, Brazil

[6] Hosp SEPACO, Sao Paulo, SP, Brazil

[7] Pontificia Univ Catolica PUC RS, Porto Alegre, RS, Brazil

[8] Hosp Assuncao, Sao Bernardo Do Campo, SP, Brazil

[9] Hosp Martagao Gesteira, Salvador, BA, Brazil

[10] Hosp Couto Maia, Salvador, BA, Brazil

[11] Univ Estado Rio de Janeiro UERJ, Hosp Pedro Ernesto, Rio De Janeiro, RJ, Brazil

[12] Hosp Rios DOr, Rio De Janeiro, RJ, Brazil

[13] Hosp Quinta DOr, Rio De Janeiro, RJ, Brazil

[14] Hosp Sino Brasileiro, Osasco, SP, Brazil

[15] Hosp Pedidtr Unimed, Belem, Para, Brazil

[16] Hosp Real DOr, Rio De Janeiro, RJ, Brazil

[17] Hosp Caxias DOr, Duque De Caxias, RJ, Brazil

[18] Hosp Jutta Batista, Rio De Janeiro, RJ, Brazil

[19] Hosp Niteroi DOr, Rio De Janeiro, RJ, Brazil

[20] Fiocruz MS, Inst Fernandes Figueira, Rio De Janeiro, RJ, Brazil

[21] Hosp Estadual Crianca, Rio De Janeiro, RJ, Brazil

[22] Hosp Norte DOr, Rio De Janeiro, RJ, Brazil

[23] Santa Casa Misericordia, Hosp Santa Izabel, Salvador, BA, Brazil

[24] Hosp Crianca, Fac Med, Sao Jose Do Rio Preto, SP, Brazil

[25] Hosp Estadual Getulio Vargas, Rio De Janeiro, RJ, Brazil

[26] Brazilian Res Network Pediat Intens Care BRnet PI, Rio De Janeiro, RJ, Brazil

来源：

JORNAL DE PEDIATRIA | 2020年 / 96卷 / 05期

关键词：

COVID-19; SARS-CoV-2; Pediatric intensive care; Pediatrics; Brazil; CHILDREN;

D O I：

10.1016/j.jped.2020.07.002

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Objective: To describe the clinical characteristics of children and adolescents admitted to intensive care with confirmed COVID-19. Method: Prospective, multicenter, observational study, in 19 pediatric intensive care units. Patients aged 1 month to 19 years admitted consecutively (March-May 2020) were included. Demographic, clinical-epidemiological features, treatment, and outcomes were collected. Subgroups were compared according to comorbidities, age < 1 year, and need for invasive mechanical ventilation. A muttivariabte logistic regression model was used for predictors of severity. Results: Seventy-nine patients were included (ten with multisystemic inflammatory syndrome). Median age 4 years; 54% male (multisystemic inflammatory syndrome, 80%); 41% had comorbidities (multisystemic inflammatory syndrome, 20%). Fever (76%), cough (51%), and tachypnea (50%) were common in both groups. Severe symptoms, gastrointestinal symptoms, and higher inflammatory markers were more frequent in multisystemic inflammatory syndrome. Interstitial lung infiltrates were common in both groups, but pleural effusion was more prevalent in the multisystemic inflammatory syndrome group (43% vs. 14%). Invasive mechanical ventilation was used in 18% (median 7.5 days); antibiotics, oseltamivir, and corticosteroids were used in 76%, 43%, and 23%, respectively, but not hydroxychloroquine. The median pediatric intensive care unit length-of-stay was five days; there were two deaths (3%) in the non- multisystemic inflammatory syndrome group. Patients with comorbidities were older and comorbidities were independently associated with the need for invasive mechanical ventilation (OR 5.5; 95% CI, 1.43-21.12; p =0.01). Conclusions: In Brazilian pediatric intensive care units, COVID-19 had low mortality, age less than 1 year was not associated with a worse prognosis, and patients with multisystemic inflammatory syndrome had more severe symptoms, higher inflammatory biomarkers, and a greater predominance of mates, but only comorbidities and chronic diseases were independent predictors of severity. (C) 2020 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda.

引用

页码：582 / 592

页数：11

共 19 条

[1]

[Anonymous], 2020, SIGNAL TRANSDUCT TAR, DOI DOI 10.1038/s41392-020-0148-4

[2] Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic [J].

Belhadjer, Zahra ;

Meot, Mathilde ;

Bajolle, Fanny ;

Khraiche, Diala ;

Legendre, Antoine ;

Abakka, Samya ;

Auriau, Johanne ;

Grimaud, Marion ;

Oualha, Mehdi ;

Beghetti, Maurice ;

Wacker, Julie ;

Ovaert, Caroline ;

Hascoet, Sebastien ;

Selegny, Maelle ;

Malekzadeh-Milani, Sophie ;

Maltret, Alice ;

Bosser, Gilles ;

Giroux, Nathan ;

Bonnemains, Laurent ;

Bordet, Jeanne ;

Di Filippo, Sylvie ;

Mauran, Pierre ;

Falcon-Eicher, Sylvie ;

Thambo, Jean-Benoit ;

Lefort, Bruno ;

Moceri, Pamela ;

Houyel, Lucile ;

Renolleau, Sylvain ;

Bonnet, Damien .

CIRCULATION, 2020, 142 (05) :429-436

[3] Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020 [J].

Bialek, Stephanie ;

Gierke, Ryan ;

Hughes, Michelle ;

McNamara, Lucy A. ;

Pilishvili, Tamara ;

Skoff, Tami .

MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, 2020, 69 (14) :422-426

[4]

Cheung EW, 2020, JAMA, V32, P294

[5] Epidemiology of COVID-19 Among Children in China [J].

Dong, Yuanyuan ;

Mo, Xi ;

Hu, Yabin ;

Qi, Xin ;

Jiang, Fan ;

Jiang, Zhongyi ;

Tong, Shilu .

PEDIATRICS, 2020, 145 (06)

[6] Multisystem Inflammatory Syndrome in US Children and Adolescents [J].

Feldstein, Leora R. ;

Rose, Erica B. ;

Horwitz, Steven M. ;

Collins, Jennifer P. ;

Newhams, Margaret M. ;

Son, Mary Beth F. ;

Newburger, Jane W. ;

Kleinman, Lawrence C. ;

Heidemann, Sabrina M. ;

Martin, Amarilis A. ;

Singh, Aalok R. ;

Li, Simon ;

Tarquinio, Keiko M. ;

Jaggi, Preeti ;

Oster, Matthew E. ;

Zackai, Sheemon P. ;

Gillen, Jennifer ;

Ratner, Adam J. ;

Walsh, Rowan F. ;

Fitzgerald, Julie C. ;

Keenaghan, Michael A. ;

Alharash, Hussam ;

Doymaz, Sule ;

Clouser, Katharine N. ;

Giuliano, John S. ;

Gupta, Anjali ;

Parker, Robert M. ;

Maddux, Aline B. ;

Havalad, Vinod ;

Ramsingh, Stacy ;

Bukulmez, Hulya ;

Bradford, Tamara T. ;

Smith, Lincoln S. ;

Tenforde, Mark W. ;

Carroll, Christopher L. ;

Riggs, Becky J. ;

Gertz, Shira J. ;

Daube, Ariel ;

Lansell, Amanda ;

Coronado Munoz, Alvaro ;

Hobbs, Charlotte V. ;

Marohn, Kimberly L. ;

Halasa, Natasha B. ;

Patel, Manish M. ;

Randolph, Adrienne G. .

NEW ENGLAND JOURNAL OF MEDICINE, 2020, 383 (04) :334-346

[7] Children in Critical Care Due to Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Experience in a Spanish Hospital [J].

Garcia-Salido, Alberto ;

Leoz-Gordillo, Ines ;

Martinez de Azagra-Garde, Amelia ;

Nieto-Moro, Montserrat ;

Iglesias-Bouzas, Maria Isabel ;

Garcia-Teresa, Maria Angeles ;

Cabrero-Hernandez, Marta ;

De Lama Caro-Paton, Gema ;

Gochi Valdovinos, Ainhoa ;

Gonzalez-Brabin, Anthony ;

Serrano-Gonzalez, Ana .

PEDIATRIC CRITICAL CARE MEDICINE, 2020, 21 (08) :E576-E580

[8] COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study [J].

Goetzinger, Florian ;

Santiago-Garcia, Begona ;

Noguera-Julian, Antoni ;

Lanaspa, Miguel ;

Lancella, Laura ;

Carducci, Francesca I. Calo ;

Gabrovska, Natalia ;

Velizarova, Svetlana ;

Prunk, Petra ;

Osterman, Veronika ;

Krivec, Uros ;

Lo Vecchio, Andrea ;

Shingadia, Delane ;

Soriano-Arandes, Antoni ;

Melendo, Susana ;

Lanari, Marcello ;

Pierantoni, Luca ;

Wagner, Noemie ;

L'Huillier, Arnaud G. ;

Heininger, Ulrich ;

Ritz, Nicole ;

Bandi, Srini ;

Krajcar, Nina ;

Roglic, Srdan ;

Santos, Mar ;

Christiaens, Christelle ;

Creuven, Marine ;

Buonsenso, Danilo ;

Welch, Steven B. ;

Bogyi, Matthias ;

Brinkmann, Folke ;

Tebruegge, Marc .

LANCET CHILD & ADOLESCENT HEALTH, 2020, 4 (09) :653-661

[9]

Gonzalez-Dambrauskas S, 2020, PEDIATRICS, V324, P259

[10] Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis [J].

Huang, Ian ;

Pranata, Raymond .

JOURNAL OF INTENSIVE CARE, 2020, 8 (01)

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