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A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020.
Schuster, Jennifer E; Halasa, Natasha B; Nakamura, Mari; Levy, Emily R; Fitzgerald, Julie C; Young, Cameron C; Newhams, Margaret M; Bourgeois, Florence; Staat, Mary A; Hobbs, Charlotte V; Dapul, Heda; Feldstein, Leora R; Jackson, Ashley M; Mack, Elizabeth H; Walker, Tracie C; Maddux, Aline B; Spinella, Philip C; Loftis, Laura L; Kong, Michele; Rowan, Courtney M; Bembea, Melania M; McLaughlin, Gwenn E; Hall, Mark W; Babbitt, Christopher J; Maamari, Mia; Zinter, Matt S; Cvijanovich, Natalie Z; Michelson, Kelly N; Gertz, Shira J; Carroll, Christopher L; Thomas, Neal J; Giuliano, John S; Singh, Aalok R; Hymes, Saul R; Schwarz, Adam J; McGuire, John K; Nofziger, Ryan A; Flori, Heidi R; Clouser, Katharine N; Wellnitz, Kari; Cullimore, Melissa L; Hume, Janet R; Patel, Manish; Randolph, Adrienne G.
  • Schuster JE; Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.
  • Halasa NB; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Nakamura M; Division of Pediatric Infectious Diseases, Department of Pediatrics and Antimicrobial Stewardship Program, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Levy ER; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
  • Fitzgerald JC; Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Young CC; Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Newhams MM; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Bourgeois F; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Staat MA; Pediatric Therapeutics and Regulatory Science Initiative, Computational Health Informatics Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Hobbs CV; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Dapul H; Division of Disease, Departments of Pediatrics and Microbiology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
  • Feldstein LR; Division of Pediatric Critical Care Medicine, Department of Pediatrics, New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York, USA.
  • Jackson AM; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Mack EH; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Walker TC; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Maddux AB; Department of Pediatrics, Division of Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Spinella PC; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
  • Loftis LL; Division of Critical Care, Department of Pediatrics, Washington University School of Medicine in St Louis, St. Louis, Missouri, USA.
  • Kong M; Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.
  • Rowan CM; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Bembea MM; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA.
  • McLaughlin GE; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Hall MW; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Babbitt CJ; Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
  • Maamari M; Division of Pediatric Critical Care, Department of Pediatrics, Miller Children's and Women's Hospital of Long Beach, Long Beach, California, USA.
  • Zinter MS; Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Health Medical Center, Dallas, Texas, USA.
  • Cvijanovich NZ; Department of Pediatrics, Division of Critical Care, University of California San Francisco, San Francisco, California, USA.
  • Michelson KN; Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, Oakland, California, USA.
  • Gertz SJ; Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
  • Carroll CL; Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey, USA.
  • Thomas NJ; Division of Critical Care, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
  • Giuliano JS; Department of Pediatrics, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
  • Singh AR; Department of Pediatrics, Division of Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA.
  • Hymes SR; Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
  • Schwarz AJ; Division of Pediatric Infectious Diseases, Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, New York, USA.
  • McGuire JK; Division of Critical Care Medicine, CHOC Children's Hospital, Orange, California, USA.
  • Nofziger RA; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital and the University of Washington, Seattle, Washington, USA.
  • Flori HR; Division of Critical Care Medicine, Akron Children's Hospital, Akron, Ohio, USA.
  • Clouser KN; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan, USA.
  • Wellnitz K; Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA.
  • Cullimore ML; Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
  • Hume JR; Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska, USA.
  • Patel M; Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA.
  • Randolph AG; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Pediatric Infect Dis Soc ; 11(5): 191-198, 2022 May 30.
Article in English | MEDLINE | ID: covidwho-1621636
ABSTRACT

BACKGROUND:

It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered.

METHODS:

Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated.

RESULTS:

Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December).

CONCLUSION:

Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Experimental Studies / Prognostic study Limits: Child / Humans Country/Region as subject: North America Language: English Journal: J Pediatric Infect Dis Soc Year: 2022 Document Type: Article Affiliation country: Jpids

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Experimental Studies / Prognostic study Limits: Child / Humans Country/Region as subject: North America Language: English Journal: J Pediatric Infect Dis Soc Year: 2022 Document Type: Article Affiliation country: Jpids