Clinical and Epidemiological Characteristics of Paediatric Patients Diagnosed with COVID-19 in a Tertiary Hospital in Mexico City

Macías-Parra, Mercedes; Fortes-Gutierrez, Sofia; Aguilar-Gomez, Nancy; Díaz–García, Luisa; Otero-Mendoza, Francisco; Garza, Eduardo Arias de la; Ordoñez-Ortega, Javier; Palacios-Reyes, Debora; Diaz-Jimenez, Irma Virginia; Serrano-Sierra, Alejandro; Xochihua-Díaz, Luis; Saltigeral-Simental, Patricia

doi:10.1093/tropej/fmab025

Cited by 15 publications

(18 citation statements)

References 13 publications

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“…On the other hand, one large series from the US reported that 29.6% of the hospitalized COVID‐19 infections required intensive care unit admission, 17 while different studies from Mexico City and the USA reported that 23.0% and 39% of the children required PICU admission. 18 , 19 In our study, we didn't observe any significant difference regarding pediatric intensive care unit admission for both of the viral infections. Moreover, admission to the intensive care unit was associated with an underlying disease regardless of the type of pandemic.…”

Section: Discussioncontrasting

confidence: 57%

Comparison of the pediatric hospitalizations due to COVID‐19 and H1N1pdm09 virus infections during the pandemic period

Devrim

Böncüoğlu

Kıymet

et al. 2022

Journal of Medical Virology

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There are two major pandemics in the new millennium, including the pandemic of swine influenza and the COVID-19 pandemic. These two pandemics affected children as well as the adult population. In this case-control study, we compared children with COVID-19 infection and those with H1N1pdm09 virus infection. We also compared the demographic factors, underlying disease, and the requirement for intensive care admission between the hospitalized children with COVID-19 infection and children with H1N1pdm09 virus infection who were hospitalized during the 2009 H1N1 pandemic. In this study, we evaluated 103 patients with H1N1pdm09 virus infection and 392 patients with COVID-19 infection. The age was significantly higher in the COVID-19 patients' group compared to the pandemic influenza group (p < 0.001).The ratio of the children ≥12 years was 10.7% (n = 11) in the H1N1pdm09 virus infection and 36.2% (n = 142) in the COVID-19 group. The rate of underlying disease was significantly higher in the patients with H1N1pdm09 virus infections (p = 0.02).The prevalence of underlying disease in patients requiring PICU hospitalization was 69.2% (n = 9/13) compared to 25.7% (n = 124/482) in patients who did not require PICU hospitalization. The rate of underlying disease was significantly higher in the PICU group regardless of COVID-19 or H1N1pdm09 virus (p = 0.002). Our results suggest that older children were more hospitalized for COVID-19 infections compared to pandemic influenza. In addition, regardless of the type of pandemic infection, the underlying disease is an important factor for pediatric intensive care unit admission. This finding is important for developing strategies for the protection of children with the underlying disease in the upcoming pandemics.

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Section: Discussioncontrasting

confidence: 57%

Comparison of the pediatric hospitalizations due to COVID‐19 and H1N1pdm09 virus infections during the pandemic period

Devrim

Böncüoğlu

Kıymet

et al. 2022

Journal of Medical Virology

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“…There are very few reports on the Mexican pediatric population hospitalized with SARS-CoV-2 and, in the case of Mexico City, the clinical and epidemiological profile of this population is even less well characterized. Macias-Parra and colleagues studied a cohort ( n = 86) of pediatric patients hospitalized with SARS-CoV-2 infection at a tertiary hospital in Mexico City, finding that 40% of the patients were >12 years old, 21% manifested severe and critical disease, and the mortality of the cohort was 5% [ 12 ]. Oliver-López and colleagues studied a cohort ( n = 510) from a pediatric referral hospital in Mexico City, including inpatients and outpatients that met the criteria for a suspected case by the Mexican Epidemiological Surveillance Directorate [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological and Clinical Characteristics of Hospitalized Pediatric Patients with SARS-CoV-2 Infection in Mexico City, Mexico

Lugo-Zamudio

Aguilar-Rojas

Vázquez-Medina

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Evidence from across the world suggests that the pediatric population shows different clinical manifestations and has a lower risk of severe presentation of SARS-CoV-2 infection compared to adults. However, Mexico has one of the highest mortality rates in the pediatric population due to SARS-CoV-2 infection. Therefore, our objective was to explore the epidemiological and clinical characteristics associated with a positive confirmatory test in the Mexican pediatric population admitted to a tertiary care hospital in Mexico City. Methods. Clinical, imaging and laboratory data were retrospectively collected from 121 children hospitalized during the period from March 4th, 2020, to August 8th, 2021. The patients were identified as suspicious cases according to the guidelines of the General Directorate of Epidemiology of Mexico. Real-time polymerase chain reaction (RT-PCR) tests were used to confirm SARS-CoV-2 infection. Categorical variables were compared using the Chi-square test, and propensity score matching was performed to determine univariate and multivariate odds ratios of the population regarding a positive vs. negative SARS-CoV-2 result. Results. Of the 121 children, 36 had laboratory-confirmed SARS-CoV-2 infection. The main risk for SARS-CoV-2-associated pediatric hospitalization was contact with a family member with SARS-CoV-2. It was also found that fever and fatigue were statistically significantly associated with a positive SARS-CoV-2 test in multivariate models. Clinical and laboratory data in this Mexican hospitalized pediatric cohort differ from other reports worldwide; the mortality rate (1.6%) of the population studied was higher than that seen in reports from other countries. Conclusion. Our study found that fever and fatigue at hospital presentation as well as an antecedent exposure to a family member with SARS-CoV-2 infection were important risk factors for SARS-CoV-2 positivity in children at hospital admission.

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“…This clinical scenario has been observed in Mexican children and reported by the group of the National Institute of Paediatrics. [35] In this report, 62% of the studied population did not report previous diseases and it is conceivable that a fraction of this population had presented with this multisystem inflammatory syndrome, however, we recognize that we cannot affirm that this would have been the diagnosis. Therefore, more research is required to ascertain if this condition exists in the Mexican population.…”

Section: Discussionmentioning

confidence: 72%

Probability of Hospitalization and Death Among Covid-19 Patients With Comorbidity During Outbreaks Occurring in Mexico City

Sifuentes–Osornio

Angulo-Guerrero

De-Anda-Jáuregui

et al. 2021

Preprint

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BackgroundWorldwide, it has been observed that there is a strong association between the severity of COVID-19 and with being over 40 years of age, having diabetes mellitus (DM), hypertension and/or obesity.ObjectiveTo compare the probability of death caused by COVID-19 in patients with comorbidities during three periods defined for this study as follows: first wave (March 23 to July 12, 2020), interwave period (July 13 to October 25, 2020), and the second wave (October 26, 2020, to March 29, 2021) using the different fatality rates observed in Mexico City.MethodsThe cohort studied included individuals over 20 years of age. During the first wave (symptomatic), the interwave period, and the second wave (symptomatic and asymptomatic), participants were diagnosed using nasopharyngeal swabs taken in kiosks. Symptomatic individuals with risk factors for serious disease or death were referred to hospital. SARS-CoV-2 infection was defined by real time polymerase chain reaction in all hospitalized patients. All data from hospitalized patients and outpatients were added to the SISVER database.ResultsThe total cohort size for this study was 2,260,156 persons (having a mean age of 43.1 years). Of these, 8.6% suffered from DM, 11.6% from hypertension, and 9.7% from obesity. Of the total of 2,260,156 persons, 666,694 tested positive (29.5%) to SARS CoV-2, (with a mean age of 45). During the first wave, 82,489 tested positive; in the interwave period, 112,115; and during the second wave, 472,090. That is, a considerable increase in the number of cases of infection was observed in all age groups between the first and second waves (an increase of +472% on the first wave).Of the infected persons, a total of 85,587 (12.8%) were hospitalized: 24,023 in the first wave (29.1% of those who tested positive in this period); 16,935 (15.1%) during the interwave period, and 44,629 (9.5%) in the second wave, which represents an increase of 85.77% on the first wave.Of the hospitalized patients, there were 42,979 deaths (50.2% of those hospitalized), in the first wave, 11,964 (49.8% of those hospitalized in this period), during the interwave period, 6,794 (40.1%), and in the second wave 24,221 (54.3%), an increase of +102.4% between the first wave and the second.While within the general population, the probability of a patient dying having both COVID-19 and one of the specified comorbidities (DM, obesity, or arterial hypertension) showed a systematic reduction across all age groups, the probability of death for a hospitalized patient with comorbidities increased across all age groups during the second wave. When comparing the fatality rate of hospitalized COVID-19 patients in the second wave with those of the first wave and the interwave period, a significant increase was observed across all age groups, even in individuals without comorbidities.ConclusionThe data from this study show a considerable increase in the number of detected cases of infection in all age groups between the first and second waves. In addition, 12.8% of those infected were hospitalized for severe COVID-19, representing an increase of +85.9% from the first wave to the second. A high mortality rate was observed among hospitalized patients (>50%), as was a higher probability of death in hospitalized COVID-19 patients with comorbidities for all age groups during the second wave, although there had been a slight decrease during the interwave period.SUMMARY BOXWhat is already known?Worldwide the resurging of COVID-19 cases in waves has been observed. In Mexico, like in the rest of the world, we have observed surges of SARS CoV-2 infections, COVID-19 hospitalizations and fatal outcomes followed by decreases leading to local minima. Pre-existing health conditions such as being older, having diabetes mellitus (DM), hypertension and/or obesity has been observed to be associated with an increase in the severity of COVID-19.What are the new findings?Between the first and second waves, considerable increases were observed in the number of detected cases of infection (+472%), in the number of hospitalized subjects (+85.9%), and the number of hospitalized subjects and deaths (+102.4%) in all age groups.When analysing only hospitalized individuals, with or without comorbidities, the Case Fatality Rate was high (50.2%), the probability of death increased considerably in all age groups between the first and second waves. This increase was more noticeable in those individuals with previously identified comorbidities (DM, hypertension, or obesity).An increased probability of death among individuals without comorbidities was observed between the first and second waves.What do the new findings imply?During the second wave, demand for hospitalization increased, magnifying the impact of age and comorbidities as risk factors. This situation highlights the importance of decreasing the prevalence of comorbidities among the population.

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Clinical and Epidemiological Characteristics of Paediatric Patients Diagnosed with COVID-19 in a Tertiary Hospital in Mexico City

Cited by 15 publications

References 13 publications

Comparison of the pediatric hospitalizations due to COVID‐19 and H1N1pdm09 virus infections during the pandemic period

Comparison of the pediatric hospitalizations due to COVID‐19 and H1N1pdm09 virus infections during the pandemic period

Epidemiological and Clinical Characteristics of Hospitalized Pediatric Patients with SARS-CoV-2 Infection in Mexico City, Mexico

Probability of Hospitalization and Death Among Covid-19 Patients With Comorbidity During Outbreaks Occurring in Mexico City

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