학술논문
Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting
Document Type
article
Author
Emmerson C. F. de Farias; Manoel J. C. Pavão Junior; Susan C. D. de Sales; Luciana M. P. P. do Nascimento; Dalila C. A. Pavão; Anna P. S. Pinheiro; Andreza H. O. Pinheiro; Marília C. B. Alves; Kíssila M. M. M. Ferraro; Larisse F. Q. Aires; Luana G. Dias; Mayara M. M. Machado; Michaelle J. D. Serrão; Raphaella R. Gomes; Sara M. P. de Moraes; Gabriella M. G. Moura; Adriana M. B. de Sousa; Gabriela C. L. Pontes; Railana D. F. P. Carvalho; Cristiane T. C. Silva; Guilherme Lemes; Bruna da C. G. Diniz; Aurimery G. Chermont; Kellen F. S. de Almeida; Salma B. Saraty; Mary L. F. Maia; Miriam R. C. Lima; Patricia B. Carvalho; Renata de B. Braga; Kathia de O. Harada; Maria C. A. Justino; Gleice Clemente; Maria Teresa Terreri; Marta C. Monteiro
Source
Scientific Reports, Vol 14, Iss 1, Pp 1-13 (2024)
Subject
Language
English
ISSN
2045-2322
Abstract
Abstract SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo–18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2–28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3–202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4–13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization.