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Predictors associated with critical care need and inhospital mortality among children with laboratoryconfirmed Covid-19 infection in a high HIV burden region
European Respiratory Journal Conference: European Respiratory Society International Congress, ERS ; 60(Supplement 66), 2022.
Article in English | EMBASE | ID: covidwho-2253411
ABSTRACT

Introduction:

Despite the extra mortality associated with Covid-19 death globally, little is known on COVID-19- related pediatric mortality in Africa. We assessed predictors of critical care needs and in-hospital mortality in South African children with laboratory-confirmed SARS-CoV-2 infection. Method(s) A secondary analysis of AFREhealth cohort children (large cohort of paediatric Covid-19 clinical outcomes across six African countries) admitted to Inkosi-Albert-Luthuli hospital, KwaZulu-Natal, South Africa. We used multivariable logistic regression and cox-proportional hazards models to explore predictors for intensive care and inhospital death. Result(s) Of the 82 children with PCR-confirmed SARS-CoV-2 infection, 35(42.7%) were younger than one year and 59(71%) had a comorbidity. 37(45.2%) children required critical care and 14(17%) died. Significant predictors of critical care need were age<=1year (vs.10-12years)(aOR5.38,95%CI1.28- 22.54,p=0.02), >=1comorbidity (aOR6.62,95%CI1.49-29.53,p=0.01) and increase in blood urea nitrogen/BUN (aOR1.53,95%CI1.13-2.07,p=0.001). HIV-infection (aHR8.46,95%CI1.45-49.26,p=0.02), invasive ventilation (aHR3.59,95%CI1.01-12.16,p=0.0.048), and BUN (aHR1.06,95%CI1.01-1.11,p=0.017) predicted death. Children admitted primarily (vs referred)to a quaternary hospital were less likely to die. Conclusion(s) Children with Covid-19 have a significant hospital death rate. A timely referral system and triage of children at risk for critical care and death, like those under 1 year and with comorbidities, should minimize excess mortality, especially in high HIV-infection burden regions.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: European Respiratory Journal Conference: European Respiratory Society International Congress, ERS Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: European Respiratory Journal Conference: European Respiratory Society International Congress, ERS Year: 2022 Document Type: Article