Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units.

Autor:	Shekerdemian LS; Texas Children's Hospital, Baylor College of Medicine, Houston., Mahmood NR; Children's Healthcare of Atlanta, Atlanta, Georgia., Wolfe KK; Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Riggs BJ; Johns Hopkins Children's Center, Johns Hopkins School of Medicine, Baltimore, Maryland., Ross CE; Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts., McKiernan CA; Baystate Children's Hospital, UMass Medical School Baystate Campus, Springfield, Massachusetts., Heidemann SM; Children's Hospital of Michigan, Wayne State University, Detroit., Kleinman LC; Bristol-Myers Squibb Hospital, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey., Sen AI; NewYork-Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, New York., Hall MW; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus., Priestley MA; Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia., McGuire JK; Seattle Children's Hospital, University of Washington, Seattle., Boukas K; Children's Memorial Hermann Hospital, University of Texas, Houston., Sharron MP; Children's National Medical Center, George Washington School of Medicine, Washington, DC., Burns JP; Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	JAMA pediatrics [JAMA Pediatr] 2020 Sep 01; Vol. 174 (9), pp. 868-873.
DOI:	10.1001/jamapediatrics.2020.1948
Abstrakt:	Importance: The recent and ongoing coronavirus disease 2019 (COVID-19) pandemic has taken an unprecedented toll on adults critically ill with COVID-19 infection. While there is evidence that the burden of COVID-19 infection in hospitalized children is lesser than in their adult counterparts, to date, there are only limited reports describing COVID-19 in pediatric intensive care units (PICUs). Objective: To provide an early description and characterization of COVID-19 infection in North American PICUs, focusing on mode of presentation, presence of comorbidities, severity of disease, therapeutic interventions, clinical trajectory, and early outcomes. Design, Setting, and Participants: This cross-sectional study included children positive for COVID-19 admitted to 46 North American PICUs between March 14 and April 3, 2020. with follow-up to April 10, 2020. Main Outcomes and Measures: Prehospital characteristics, clinical trajectory, and hospital outcomes of children admitted to PICUs with confirmed COVID-19 infection. Results: Of the 48 children with COVID-19 admitted to participating PICUs, 25 (52%) were male, and the median (range) age was 13 (4.2-16.6) years. Forty patients (83%) had significant preexisting comorbidities; 35 (73%) presented with respiratory symptoms and 18 (38%) required invasive ventilation. Eleven patients (23%) had failure of 2 or more organ systems. Extracorporeal membrane oxygenation was required for 1 patient (2%). Targeted therapies were used in 28 patients (61%), with hydroxychloroquine being the most commonly used agent either alone (11 patients) or in combination (10 patients). At the completion of the follow-up period, 2 patients (4%) had died and 15 (31%) were still hospitalized, with 3 still requiring ventilatory support and 1 receiving extracorporeal membrane oxygenation. The median (range) PICU and hospital lengths of stay for those who had been discharged were 5 (3-9) days and 7 (4-13) days, respectively. Conclusions and Relevance: This early report describes the burden of COVID-19 infection in North American PICUs and confirms that severe illness in children is significant but far less frequent than in adults. Prehospital comorbidities appear to be an important factor in children. These preliminary observations provide an important platform for larger and more extensive studies of children with COVID-19 infection.
Databáze:	MEDLINE
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