Predictors of severity in severe respiratory infection in children with COVID‐19 respiratory infection in a developing country

Abstract

On March 11, 2020, the WHO declared the COVID‐19 pandemic. This name was given to the disease caused by the SARS‐CoV 2 virus at its outbreak in December 2019 in Wuhan, Hubei, China. In Colombia, a significant number of cases have been confirmed. The aim of this study was to evaluate children with respiratory symptoms caused by SARS‐CoV2 infection, identifying independent predictors of risk of having a severe illness, thus leading to an early approach and intervention in our patients, especially in children with comorbidities. An analytical cross‐sectional study was conducted between April 1, 2020 and March 31, 2021 at a fourth‐level referral institution in Bogotá on patients under 18 years of age with respiratory symptoms and a COVID‐19 diagnosis confirmed in the laboratory. An explanatory binary logistic regression model was performed with an outcome variable of admission to the intensive care unit. A total of 385 children were included in the study, with ages between 9 months and 17 years of age; 50.1% were male, and the ICR was 9.75 years. 41.6% had some comorbidity, 13.5% were admitted to the pediatric ICU, and 3.6% of the total number of patients died. The predictor variables were: use of antibiotics in the first 24 h, neurological comorbidity, and consolidation shown in the chest X‐ray. This explains 38.7% of the variability of the variable. In this cohort of patients with COVID‐19‐associated respiratory symptoms, we identified predictors of severity, so we consider that these patients require a risk approach that allows timely and adequate care.

Coronavirus disease 2019 vaccine in pediatric post‐kidney transplantation

“…The response after the two‐dose series is consistent with prior reports in pediatric SOT patients 47–52 and better than in the adult population 45,53 . Unlike for the adult transplant population 45,54–56 adding a third dose for the pediatric kidney transplant recipients may not be necessary to improve seroconversion rates (i.e., S antibody titer). Despite the limitation of the small sample size, it is noteworthy that the seroconversion after a two‐dose series was significantly better in younger age groups than that in the adult population, supporting the argument that pediatric SOT recipients can mount a more robust measured antibody response to vaccination than adult patients, as is consistent with prior reports 21,42,57,58 …”

“…The response after the two-dose series is consistent with prior reports in pediatric SOT patients [47][48][49][50][51][52] and better than in the adult population. 45,53 Unlike for the adult transplant population 45,[54][55][56] F I G U R E 1 Time to infection Kaplan-Meier curve by response.…”