ABSTRACT
Abstract Objective To describe the clinical characteristics, laboratory parameters, treatment, and predictors of an unfavorable outcome of critically ill children with SARS-CoV-2 infection. Method This was a prospective observational study performed in a pediatric intensive care unit (PICU) of a tertiary care COVID referral hospital among critically ill children in the age group 1 month - 12 years admitted due to SARS-CoV-2 infection from June to December 2020. Demographic, clinical profile, pSOFA and PRISM III scores, laboratory parameters, treatment, and outcomes of the patients were recorded. Children who had a prolonged PICU stay (>14 days) or died were compared with those who were discharged from PICU within 14 days to assess predictors of unfavorable outcomes. Results PICU admission rate among hospitalized SARS-CoV-2 infected children was 22.1% (92/416). Infants comprised the majority of the ICU population. Invasive mechanical ventilation and inotropic support were required for 28.3% and 37% of patients, respectively. Remdesivir, IVIg, and steroids were administered to 15.2%, 26.1%, and 54.3% of the subjects, respectively. The mortality rate was 7.6 %. MIS-C patients were older, less comorbid, and required less ventilator support but more inotrope support than acute severe COVID-19 patients. Predictors of unfavorable outcomes were age < 1 year, fever duration > 5 days, respiratory distress, shock, comorbidity, elevated CRP (> 50 mg/L), procalcitonin (> 6 ng/L), D-dimer (> 6 µg/L) and arterial lactate (> 2 mmol/L). Conclusion Critically ill children with unfavorable outcomes were predominantly infants, comorbid, prolonged fever, respiratory distress, shock and elevated inflammatory markers, D-dimer and lactate. These factors may be useful for watchful monitoring and early intervention.
ABSTRACT
Objective: To determine the clinical presentation and outcome of children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the third wave of the pandemic in India. Method: A review of hospital records was done at a tertiary care hospital, for children seen between 1 and 25 January, 2022. Result: Out of total 112 SARS-CoV-2 positive patients, 17 were hospitalized and 95 were treated in the outpatient department. Among non-hospitalized children, fever was the commonest feature (72, 75.7%), followed by sneezing, and loss of appetite. The median (IQR) duration of symptoms was 2.5 (1.5) days. Among hospitalized children, 10 had co-morbidities and one-third required intensive care unit admission. MIS-C was diagnosed in four patients. Out of 4 mechanically ventilated patients, two had coronavirus disease (COVID) pneumonia. The mean (SD) length of hospital stay was 7.5 (2.5) days. One child with leukemia died during management. Conclusion: During the third wave of the pandemic, most children had symptomatic illnesses, but recovery was fast among non-hospitalized children.
ABSTRACT
This hospital-based study describes the antibiotic sensitivity of 66 S. aureus isolates from the admitted children (age 0-18 y) in a tertiary hospital of Kolkata, India. Methicillin-resistant S. aureus constituted 16.7% (n=11) of the isolates. Clindamycin-resistance was observed in 60% and 82% of methicillin-sensitive and methicillin-resistant strains, respectively.