Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth - 22/02/21
, Carlos R. Oliveira, MD, PhD 2, ∗, Sandra Guerguis, MD 1, Ruth Eisenberg, MS 1, Jaeun Choi, PhD 1, Mimi Kim, ScD 1, Ashraf Abdelhemid, MBBS 3, Rabia Agha, MD 4, Saranga Agarwal, MD 5, Judy L. Aschner, MD 5, Jeffrey R. Avner, MD 4, Cathleen Ballance, MD 6, Joshua Bock, BA 1, Sejal M. Bhavsar, MD 5, Melissa Campbell, MD 2, Katharine N. Clouser, MD 5, Matthew Gesner, MD 3, David L. Goldman, MD 1, Margaret R. Hammerschlag, MD 7, Saul Hymes, MD 8, Ashley Howard, DO 2, Hee-jin Jung, MD 5, Stephan Kohlhoff, MD 7, Tsoline Kojaoghlanian, MD 4, Rachel Lewis, MD 5, Sharon Nachman, MD 8, Srividya Naganathan, MD 6, Elijah Paintsil, MD 2, Harpreet Pall, MD 6, Sharlene Sy, MD 1, Stephen Wadowski, MD 7, Elissa Zirinsky, MD 2, Michael D. Cabana, MD, MPH 1, Betsy C. Herold, MD 1The Tri-State Pediatric COVID-19 Research Consortium
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Abstract |
Objective |
To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity.
Study design |
We conducted a multicenter, retrospective, and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at 8 sites in New York, New Jersey, and Connecticut.
Results |
We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into 3 groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% vs 18%, P = .02). Seven patients (2%) died and 114 (41%) were admitted to the intensive care unit. In multivariable analyses, obesity (OR 3.39, 95% CI 1.26-9.10, P = .02) and hypoxia on admission (OR 4.01; 95% CI 1.14-14.15; P = .03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR 8.33 per unit decrease in 109 cells/L, 95% CI 2.32-33.33, P = .001) and greater C-reactive protein (OR 1.06 per unit increase in mg/dL, 95% CI 1.01-1.12, P = .017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity.
Conclusions |
We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, biomarkers
Abbreviations : ALC, COVID-19, CRP, ICU, MIS-C, PCR, SARS-CoV-2, SES
Plan
| M.D.C. serves on the Editorial Board for The Journal of Pediatrics and is a member of the United States Preventive Services Task Force. This manuscript does not necessarily reflect the views of the United States Preventive Services Task Force. The other authors declare no conflicts of interest. |
Vol 230
P. 23 - mars 2021 Retour au numéro
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