The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience
Journal of Infection and Chemotherapy
; 29(1):20-25, 2023.
Article
in English
| Scopus | ID: covidwho-2238459
ABSTRACT
Objectives:
To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country.Methods:
A retrospective chart review of children 0–14 years old admitted to PICU with a viral infection.Results:
Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001).Conclusion:
Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
Adolescent; Child; Child, Preschool; COVID-19; Humans; Infant; Infant, Newborn; Intensive Care Units, Pediatric; Length of Stay; Pandemics; Retrospective Studies; Tertiary Care Centers; Virus Diseases; Article; artificial ventilation; Bocavirus infection; childhood mortality; cohort analysis; comorbidity; comparative study; coronavirus disease 2019; critical illness; critically ill patient; disease burden; endemic disease; endotracheal intubation; Enterovirus infection; experience; female; hospital admission; human; human adenovirus infection; Human metapneumovirus infection; in-hospital mortality; influenza; influenza A (H1N1); influenza B; invasive ventilation; major clinical study; male; medical record review; Middle East respiratory syndrome; mortality rate; multiple organ failure; newborn; noninvasive ventilation; outcome assessment; pandemic; Pediatric Index of Mortality; pediatric intensive care unit; pediatric patient; preschool child; prevalence; prognosis; respiratory syncytial virus infection; retrospective study; Rhinovirus infection; survival; tertiary care center; trend study; virus infection; Infections; Mechanical ventilation; Pediatric intensive care; Viral co-infection; Viral diseases; Viruses
Full text:
Available
Collection:
Databases of international organizations
Database:
Scopus
Language:
English
Journal:
Journal of Infection and Chemotherapy
Year:
2023
Document Type:
Article
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