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High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru

INTRODUCTION: Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We p...

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Autores principales: Coronado Munoz, Alvaro, Tasayco, Jaime, Morales, Willy, Moreno, Luis, Zorrilla, David, Stapleton, Angie, Pajuelo, Patricia, Reyes, Giuliana, Estupiñan, Matilde, Seminario, Ricardo, Ortiz, Manuel, Domínguez, Jesús
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8090521/
https://www.ncbi.nlm.nih.gov/pubmed/33941862
http://dx.doi.org/10.1038/s41390-021-01547-x
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author Coronado Munoz, Alvaro
Tasayco, Jaime
Morales, Willy
Moreno, Luis
Zorrilla, David
Stapleton, Angie
Pajuelo, Patricia
Reyes, Giuliana
Estupiñan, Matilde
Seminario, Ricardo
Ortiz, Manuel
Domínguez, Jesús
author_facet Coronado Munoz, Alvaro
Tasayco, Jaime
Morales, Willy
Moreno, Luis
Zorrilla, David
Stapleton, Angie
Pajuelo, Patricia
Reyes, Giuliana
Estupiñan, Matilde
Seminario, Ricardo
Ortiz, Manuel
Domínguez, Jesús
author_sort Coronado Munoz, Alvaro
collection PubMed
description INTRODUCTION: Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting. METHODS: Prospective case–control study that included patients <17 years old admitted to a pediatric critical care unit with a positive test confirming COVID-19. The primary outcome was mortality. Fisher’s exact test and the Mann–Whitney U test were used for the analysis. RESULTS: Forty-seven patients were admitted to critical care. The mortality of our study is 21.3%. The mortality of patients with neurological presentation was 45.5%, which was significantly higher than the mortality of acute COVID-19 (26.7%) and MIS-C (4.8%), p 0.18. Other risk factors for mortality in our cohort were strokes and comorbidities. Only one patient presenting with hemorrhagic stroke had an undiagnosed comorbidity. CONCLUSION: Cerebrovascular events associated with COVID-19 in pediatric patients, including infants, must be recognized as one of the more severe presentations of this infection in pediatric patients. IMPACT: Pediatric patients with COVID-19 can present with hemorrhagic and ischemic strokes on presentation. Neurological presentation in pediatric patients with COVID-19 has high mortality. Mortality of pediatric patients with COVID-19 is associated with comorbidities. Pediatric presentation and outcomes of COVID-19 in different regions can be novel to previously described.
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spelling pubmed-80905212021-05-03 High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru Coronado Munoz, Alvaro Tasayco, Jaime Morales, Willy Moreno, Luis Zorrilla, David Stapleton, Angie Pajuelo, Patricia Reyes, Giuliana Estupiñan, Matilde Seminario, Ricardo Ortiz, Manuel Domínguez, Jesús Pediatr Res Clinical Research Article INTRODUCTION: Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting. METHODS: Prospective case–control study that included patients <17 years old admitted to a pediatric critical care unit with a positive test confirming COVID-19. The primary outcome was mortality. Fisher’s exact test and the Mann–Whitney U test were used for the analysis. RESULTS: Forty-seven patients were admitted to critical care. The mortality of our study is 21.3%. The mortality of patients with neurological presentation was 45.5%, which was significantly higher than the mortality of acute COVID-19 (26.7%) and MIS-C (4.8%), p 0.18. Other risk factors for mortality in our cohort were strokes and comorbidities. Only one patient presenting with hemorrhagic stroke had an undiagnosed comorbidity. CONCLUSION: Cerebrovascular events associated with COVID-19 in pediatric patients, including infants, must be recognized as one of the more severe presentations of this infection in pediatric patients. IMPACT: Pediatric patients with COVID-19 can present with hemorrhagic and ischemic strokes on presentation. Neurological presentation in pediatric patients with COVID-19 has high mortality. Mortality of pediatric patients with COVID-19 is associated with comorbidities. Pediatric presentation and outcomes of COVID-19 in different regions can be novel to previously described. Nature Publishing Group US 2021-05-03 2022 /pmc/articles/PMC8090521/ /pubmed/33941862 http://dx.doi.org/10.1038/s41390-021-01547-x Text en © The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Clinical Research Article
Coronado Munoz, Alvaro
Tasayco, Jaime
Morales, Willy
Moreno, Luis
Zorrilla, David
Stapleton, Angie
Pajuelo, Patricia
Reyes, Giuliana
Estupiñan, Matilde
Seminario, Ricardo
Ortiz, Manuel
Domínguez, Jesús
High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru
title High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru
title_full High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru
title_fullStr High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru
title_full_unstemmed High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru
title_short High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru
title_sort high incidence of stroke and mortality in pediatric critical care patients with covid-19 in peru
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8090521/
https://www.ncbi.nlm.nih.gov/pubmed/33941862
http://dx.doi.org/10.1038/s41390-021-01547-x
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