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Coronavirus Disease 2019-Associated PICU Admissions: A Report From the Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study Registry.
Tripathi, Sandeep; Gist, Katja M; Bjornstad, Erica C; Kashyap, Rahul; Boman, Karen; Chiotos, Kathleen; Gharpure, Varsha P; Dapul, Heda; Sayed, Imran A; Kuehne, Joshua; Heneghan, Julia A; Gupta, Manoj; Khandhar, Paras B; Menon, Shina; Gupta, Neha; Kumar, Vishakha K; Retford, Lynn; Zimmerman, Jerry; Bhalala, Utpal S.
  • Tripathi S; Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital of Illinois, OSF St Francis Medical Centre at Peoria, Peoria, IL.
  • Gist KM; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO.
  • Bjornstad EC; Division of Pediatric Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
  • Kashyap R; Department of Anesthesia and Critical Care, Mayo Clinic, Rochester, MN.
  • Boman K; Society of Critical Care Medicine, Mount Prospect, IL.
  • Chiotos K; Division of Pediatric Critical Care, Department of Anesthesia and Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA.
  • Gharpure VP; Division of Pediatric Critical Care. Department of Pediatrics, Advocate Children's Hospital, Park Ridge, IL.
  • Dapul H; Division of Pediatric Critical Care, Department of Pediatrics. Hassenfield Children's Hospital at NYU Langone, New York, NY.
  • Sayed IA; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO.
  • Kuehne J; Baylor College of Medicine, Houston, TX.
  • Heneghan JA; Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.
  • Gupta M; Division of Pediatric Cardiology, Department of Pediatrics. Lincoln Medical and Mental Health Center, Lincoln Hospital, Bronx, NY.
  • Khandhar PB; Division of Pediatric Critical Care, Department of Pediatrics, Beaumont Children's Hospital, Royal Oak, MI.
  • Menon S; Division of Pediatric Nephrology, Department of Pediatrics. Seattle Children's Hospital/University of Washington, Seattle Children's Hospital, Seattle, WA.
  • Gupta N; Division of Pediatric Critical Care, Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, OK.
  • Kumar VK; Society of Critical Care Medicine, Mount Prospect, IL.
  • Retford L; Society of Critical Care Medicine, Mount Prospect, IL.
  • Zimmerman J; Division of Pediatric Nephrology, Department of Pediatrics. Seattle Children's Hospital/University of Washington, Seattle Children's Hospital, Seattle, WA.
  • Bhalala US; Division of Pediatric Critical Care, Department of Pediatrics, The Children's Hospital of San Antonio, San Antonio and Baylor College of Medicine, Houston, TX.
Pediatr Crit Care Med ; 22(7): 603-615, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1291942
ABSTRACT

OBJECTIVES:

To compare clinical characteristics and outcomes of children admitted to the PICU for severe acute respiratory syndrome coronavirus 2-related illness with or without multisystem inflammatory syndrome in children. The secondary objective was to identify explanatory factors associated with outcome of critical illness defined by a composite index of in-hospital mortality and organ system support requirement.

DESIGN:

Retrospective cohort study.

SETTING:

Thirty-eight PICUs within the Viral Infection and Respiratory Illness Universal Study registry from March 2020 to January 2021. PATIENTS Children less than 18 years with severe acute respiratory syndrome coronavirus 2-related illness with or without multisystem inflammatory syndrome in children. MEASUREMENTS AND MAIN

RESULTS:

Of 394 patients, 171 (43.4%) had multisystem inflammatory syndrome in children. Children with multisystem inflammatory syndrome in children were more likely younger (2-12 yr vs adolescents; p < 0.01), Black (35.6% vs 21.9%; p < 0.01), present with fever/abdominal pain than cough/dyspnea (p < 0.01), and less likely to have comorbidities (33.3% vs 61.9%; p < 0.01) compared with those without multisystem inflammatory syndrome in children. Inflammatory marker levels, use of inotropes/vasopressors, corticosteroids, and anticoagulants were higher in multisystem inflammatory syndrome in children patients (p < 0.01). Overall mortality was 3.8% (15/394), with no difference in the two groups. Diagnosis of multisystem inflammatory syndrome in children was associated with longer duration of hospitalization as compared to nonmultisystem inflammatory syndrome in children (7.5 d[interquartile range, 5-11] vs 5.3 d [interquartile range, 3-11 d]; p < 0.01). Critical illness occurred in 164 patients (41.6%) and was more common in patients with multisystem inflammatory syndrome in children compared with those without (55.6% vs 30.9%; p < 0.01). Multivariable analysis failed to show an association between critical illness and age, race, sex, greater than or equal to three signs and symptoms, or greater than or equal to two comorbidities among the multisystem inflammatory syndrome in children cohort. Among nonmultisystem inflammatory syndrome in children patients, the presence of greater than or equal to two comorbidities was associated with greater odds of critical illness (odds ratio 2.95 [95% CI, 1.61-5.40]; p < 0.01).

CONCLUSIONS:

This study delineates significant clinically relevant differences in presentation, explanatory factors, and outcomes among children admitted to PICU with severe acute respiratory syndrome coronavirus 2-related illness stratified by multisystem inflammatory syndrome in children.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Child / Humans Language: English Journal: Pediatr Crit Care Med Journal subject: Pediatrics / Critical Care Year: 2021 Document Type: Article Affiliation country: PCC.0000000000002760

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Child / Humans Language: English Journal: Pediatr Crit Care Med Journal subject: Pediatrics / Critical Care Year: 2021 Document Type: Article Affiliation country: PCC.0000000000002760