The Impact of Steroids on Outcomes of Children Admitted to the Hospital with Non Misc Covid19: An Analysis from the Sccm Discovery Network Virus Registry

ABSTRACT

BACKGROUND AND AIM: Evidence for therapies for pediatric COVID-19 is limited. Primary aim was to study the effect of steroid administration within 2 days of admission for pediatric non-MIS-C-COVID-19 on hospital and ICU length of stay (LOS). The secondary aim was to study its effect on inflammation and fever defervescence. METHOD(S) A retrospective study of 1163 children hospitalized with non-MISC-COVID-19, from 03/20 to 09/21, from 58 hospitals (7 countries, 92% US), in the Viral Infection and Respiratory Illness Universal Study (VIRUS) registry. Effect of steroid administration <= 2 days of admission on hospital and ICU LOS was studied using intention to treat analysis, adjusted for confounders by multivariable mixed linear regression. RESULT(S) Median age was 7(IQR 0.9,14.3) years. 184(15.8%) children who received steroids within <= 2 days were compared to 979 (84.1%) children who did not. 56.5% (n=658) required respiratory support. Patients in the steroid group were older, with higher severity of illness. A greater proportion required respiratory and vasoactive support. On multivariable linear regression with random intercept for site (Table), there was no significant difference in hospital LOS (exponentiated [exp] co-efficient 0.92, 95%CI = 0.77, 1.10, p=0.374) or ICU LOS (exp co-efficient 1.02, 95%CI = 0.78, 1.34, p=0.864) between the groups. There was no significant difference in time to fever defervescence and normalization of inflammatory mediators by Day 3. CONCLUSION(S) In pediatric non-MIS-C COVID-19, steroid treatment <= 2 days of hospital admission did not show a statistically significant effect on hospital or ICU LOS. (Table Presented).