Risk factors for severe COVID-19 infection in Brazilian children

Hendler, Jordana Vaz; Lago, Patrícia Miranda do; Müller, G; Santana, João Carlos Batista; Piva, Jefferson Pedro; Daudt, Liane Esteves

doi:10.1016/j.bjid.2021.101650

Cited by 19 publications

(26 citation statements)

References 22 publications

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“…Data from other studies are inconsistent in this regard. Li et al ( 17 ) results are aligned with our findings whereas others report a greater proportion of comorbidities, for instance, studies from Peru (42%), Argentina (53.9%), and Brazil (38.9%) ( 18 – 20 ).…”

Section: Discussionsupporting

confidence: 91%

“…On the other hand, a Peruvian study found higher rates of severe disease with 16.8% affected with MIS-C ( 18 , 19 , 32 ). Compared with other studies, our PICU admission rate (8%) was similar to that described by Ferraro et al ( 18 – 20 , 32 , 33 ) (6.8%) and is rather average. PICU admissions figures range from 0.5 up to 28%.…”

Section: Discussionsupporting

confidence: 89%

“…Patients with chronic illnesses such as pulmonary disease, immunodeficiencies, congenital heart disease, or neurological disease are more susceptible to death ( 22 , 23 , 38 ). Higher mortality rates have been reported and probably are explained by healthcare access constraints in the studied populations ( 18 , 20 ).…”

Section: Discussionmentioning

confidence: 77%

“…Hospital-acquired COVID-19 infections were rare (0.5%) and at a rate lower than previously estimated. For instance, Hendler et al ( 20 ) found a frequency of 7.9% of nosocomial infections. We strongly believe that our diagnostic strategy contributed to these numbers.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

et al. 2022

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Objective:COVID-19 infections have shown a different behavior in children than in adults. The objective of this study was to describe the clinical characteristics and severity of SARS-CoV-2 infection in pediatric patients seen at a reference hospital in Colombia.MethodA descriptive, observational study in patients under the age of 18 years with a positive test for SARS-CoV-2 infection (RT-PCR or antigen) between April 2020 and March 2021. Multiple variables were studied, including demographic data, clinical characteristics, lab measurements, treatments administered, intensive care unit admission, and mortality.ResultsA total of 361 patients were included of whom 196 (54%) were males. The median age was 3 years. Of all the patients, 65 (18%) were asymptomatic. The majority of patients had no comorbidities (n = 225, 76%). In those who were symptomatic (n = 296, 82%), the most frequent complaints were fever (n = 178, 60%), nasal congestion (n = 164, 55%) and cough (n = 149, 50%). Chest x-rays were normal in 73 patients (50%). When abnormalities were found, interstitial (29%) and alveolar (12%) patterns were the most prevalent. One hundred and fifty-seven children (53%) required general ward hospitalization, and 24 patients (8%) required pediatric intensive care admission. The global mortality was 0.8% (3 patients).ConclusionsThe majority of cases were asymptomatic or mild. However, a significant percentage of patients required general ward admission, and some even required intensive care. The main symptom of COVID-19 infections in newborns was apnea. A second COVID-19 RT-PCR may be necessary to detect infections in critically ill patients with a high clinical suspicion of the disease if an initial test was negative.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

et al. 2022

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“…These patients often present non-specific signs and symptoms, very similar to other common viral conditions, making the diagnosis of COVID-19 a challenge in pediatrics (6,7). In addition, 2-4% evolve more severely, requiring hospitalization and intensive care (8)(9)(10). The risk factors for unfavorable evolution as well as the clinical manifestations and evolution of COVID-19 in children with comorbidities are still unknown.…”

Section: Introductionmentioning

confidence: 99%

Clinical Manifestations and Complications of Children With COVID-19 Compared to Other Respiratory Viral Infections: A Cohort Inpatient Study From Rio de Janeiro, Brazil

et al. 2022

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IntroductionThe coronavirus disease-2019 (COVID-19) clinical manifestations in children and adolescents are diverse, despite the respiratory condition being the main presentation. Factors such as comorbidities and other respiratory infections may play a role in the initial presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to describe the epidemiological aspects, clinical, and laboratory manifestations of pediatric patients admitted to a tertiary pediatric hospital in Rio de Janeiro, diagnosed with COVID-19, and compare these with other viral conditions during the first year of the SARS-CoV-2 pandemic.MethodsAll patients under 18 years of age that were admitted with upper airway infection were enrolled and followed up for 30 days. The main dependent variable was the laboratorial diagnosis of SARS-CoV-2, and independent variables were studied through logistic regression.ResultsA total of 533 patients were recruited, and 105 had confirmed SARS-CoV-2 infection. Detection of other viruses occurred in 34% of 264 tested participants. Six patients died (two in SARS-CoV-2 infected group). The variables independently associated with COVID-19 were older age (OR = 1.1, 95% CI = 1.0–1.1), lower leukocytes count at entry (OR = 0.9, 95% CI = 0.8–0.9), and contact with suspected case (OR = 1.6, 95% CI = 1.0–2.6). Patients with COVID-19 presented higher odds to be admitted in an intensive care unit (OR = 1.99, 95% CI = 1.08–3.66).ConclusionsEven during the SARS-CoV-2 pandemic, several other respiratory viruses were present in admitted pediatric patients. Variables associated with COVID-19 infection were older age, lower leukocytes count at entry, and a domiciliary suspect contact. Although patients with COVID-19 were more frequently admitted to ICU, we did not observe higher mortality in this group.

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

Beltran¹,

Osorio²,

Restrepo

et al. 2023

Journal of Medical Virology

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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.

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Risk factors for severe COVID-19 infection in Brazilian children

Cited by 19 publications

References 22 publications

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

Clinical Manifestations and Complications of Children With COVID-19 Compared to Other Respiratory Viral Infections: A Cohort Inpatient Study From Rio de Janeiro, Brazil

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

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