ABSTRACT
OBJECTIVES: The aim of this study was to describe severe forms of novel coronavirus disease 2019 in children, including patient characteristics, clinical, laboratory, and imaging findings, as well as the disease management and outcomes. METHODS: This was a retrospective, single-center, observational study conducted in a pediatric intensive and high-dependency care unit (PICU, HDU) in an urban hospital in Paris. All patients, aged from 1 month to 18 years, admitted for confirmed or highly suspected SARS-CoV-2 were included. RESULTS: We analyzed the data of 27 children. Comorbidities (n=19, 70%) were mainly neurological (n=7), respiratory, (n=4), or sickle cell disease (n=4). SARS-CoV-2 PCR results were positive in 24 children (nasopharyngeal swabs). The three remaining children had a chest CT scan consistent with COVID-19. Respiratory involvement was observed in 24 patients (89%). Supportive treatments were invasive mechanical ventilation (n=9), catecholamine (n=4), erythropheresis (n=4), renal replacement therapy (n=1), and extracorporeal membrane oxygenation (n=1). Five children died, of whom three were without past medical history. CONCLUSION: This study highlighted the large spectrum of clinical presentation and time course of disease progression as well as the non-negligible occurrence of pediatric life-threatening and fatal cases of COVID-19 mostly in patients with comorbidities. Additional laboratory investigations are needed to further analyze the mechanism underlying the variability of SARS-Cov-2 pathogenicity in children.
Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Adolescent , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Child , Child, Preschool , Clinical Laboratory Techniques , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Disease Progression , Female , Humans , Infant , Male , Pandemics , Paris/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Severity of Illness IndexABSTRACT
Concern has been raised on sickle cell disease (SCD) patients and the new viral infection with SARS-COV-2 since SCD patients are particularly prone to infectious diseases and acute chest syndrome (ACS). Although case reports have been published to describe COVID-19 related ACS in adult patients (1-4), pediatric data are lacking.