Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between...

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Detalles Bibliográficos
Autores principales: Marques, Heloisa Helena de Sousa, Pereira, Maria Fernanda Badue, dos Santos, Angélica Carreira, Fink, Thais Toledo, de Paula, Camila Sanson Yoshino, Litvinov, Nadia, Schvartsman, Claudio, Delgado, Artur Figueiredo, Gibelli, Maria Augusta Bento Cicaroni, de Carvalho, Werther Brunow, Odone, Vicente, Tannuri, Uenis, Carneiro-Sampaio, Magda, Grisi, Sandra, Duarte, Alberto José da Silva, Antonangelo, Leila, Francisco, Rossana Pucineli Vieira, Okay, Thelma Suely, Batisttella, Linamara Rizzo, de Carvalho, Carlos Roberto Ribeiro, Brentani, Alexandra Valéria Maria, Silva, Clovis Artur, Eisencraft, Adriana Pasmanik, Rossi, Alfio, Fante, Alice Lima, Cora, Aline Pivetta, Reis, Amelia Gorete A. de Costa, Ferrer, Ana Paula Scoleze, de Andrade, Anarella Penha Meirelles, Watanabe, Andreia, Gonçalves, Angelina Maria Freire, Waetge, Aurora Rosaria Pagliara, Silva, Camila Altenfelder, Ceneviva, Carina, Lazari, Carolina dos Santos, Abellan, Deipara Monteiro, dos Santos, Emilly Henrique, Sabino, Ester Cerdeira, Bianchini, Fabíola Roberta Marim, Alcantara, Flávio Ferraz de Paes, Ramos, Gabriel Frizzo, Leal, Gabriela Nunes, Rodriguez, Isadora Souza, Pinho, João Renato Rebello, Carneiro, Jorge David Avaizoglou, Paz, Jose Albino, Ferreira, Juliana Carvalho, Ferranti, Juliana Ferreira, Ferreira, Juliana de Oliveira Achili, Framil, Juliana Valéria de Souza, da Silva, Katia Regina, Kanunfre, Kelly Aparecida, Bastos, Karina Lucio de Medeiros, Galleti, Karine Vusberg, Cristofani, Lilian Maria, Suzuki, Lisa, Campos, Lucia Maria Arruda, Perondi, Maria Beatriz de Moliterno, Diniz, Maria de Fatima Rodrigues, Fonseca, Maria Fernanda Mota, Cordon, Mariana Nutti de Almeida, Pissolato, Mariana, Peres, Marina Silva, Garanito, Marlene Pereira, Imamura, Marta, Dorna, Mayra de Barros, Luglio, Michele, Rocha, Mussya Cisotto, Aikawa, Nadia Emi, Degaspare, Natalia Viu, Sakita, Neusa Keico, Udsen, Nicole Lee, Scudeller, Paula Gobi, Gaiolla, Paula Vieira de Vincenzi, Severini, Rafael da Silva Giannasi, Rodrigues, Regina Maria, Toma, Ricardo Katsuya, de Paula, Ricardo Iunis Citrangulo, Palmeira, Patricia, Forsait, Silvana, Farhat, Sylvia Costa Lima, Sakano, Tânia Miyuki Shimoda, Koch, Vera Hermina Kalika, Cobello, Vilson
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Medicina / USP 2021
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595603/
https://www.ncbi.nlm.nih.gov/pubmed/34852143
http://dx.doi.org/10.6061/clinics/2021/e3488
Descripción
Sumario:OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

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