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Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran

INTRODUCTION: COVID-19 clinical course, effective therapeutic regimen, and poor prognosis risk factors in pediatric cases are still under investigation and no approved vaccinehas been introduced for them. METHODS: This cross-sectional study evaluated different aspect of COVID-19 infection in hospita...

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Autores principales: Madani, Sedigheh, Shahin, Sarvenaz, Yoosefi, Moein, Ahmadi, Naser, Ghasemi, Erfan, Koolaji, Sogol, Mohammadi, Esmaeil, Mohammadi Fateh, Sahar, Hajebi, Amirali, Kazemi, Ameneh, Pakatchian, Erfan, Rezaei, Negar, Jamshidi, Hamidreza, Larijani, Bagher, Farzadfar, Farshad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660655/
https://www.ncbi.nlm.nih.gov/pubmed/34893036
http://dx.doi.org/10.1186/s12887-021-03030-2
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author Madani, Sedigheh
Shahin, Sarvenaz
Yoosefi, Moein
Ahmadi, Naser
Ghasemi, Erfan
Koolaji, Sogol
Mohammadi, Esmaeil
Mohammadi Fateh, Sahar
Hajebi, Amirali
Kazemi, Ameneh
Pakatchian, Erfan
Rezaei, Negar
Jamshidi, Hamidreza
Larijani, Bagher
Farzadfar, Farshad
author_facet Madani, Sedigheh
Shahin, Sarvenaz
Yoosefi, Moein
Ahmadi, Naser
Ghasemi, Erfan
Koolaji, Sogol
Mohammadi, Esmaeil
Mohammadi Fateh, Sahar
Hajebi, Amirali
Kazemi, Ameneh
Pakatchian, Erfan
Rezaei, Negar
Jamshidi, Hamidreza
Larijani, Bagher
Farzadfar, Farshad
author_sort Madani, Sedigheh
collection PubMed
description INTRODUCTION: COVID-19 clinical course, effective therapeutic regimen, and poor prognosis risk factors in pediatric cases are still under investigation and no approved vaccinehas been introduced for them. METHODS: This cross-sectional study evaluated different aspect of COVID-19 infection in hospitalized COVID-19 positive children (≺18 years oldwith laboratory confirmed COVID-19 infection, using the national COVID-19 registry for all admitted COVID-19 positive cases from February 19 until November 13,2020, in Iran. RESULTS: We evaluated 6610 hospitalized children. Fifty-four percent (3268) were male and one third of them were infants younger than 1 year. Mortality rate in total hospitalized children was 5.3% and in children with underlying co-morbidities (14.4%) was significantly higher (OR: 3.6 [2.7-4.7]). Chronic kidney disease (OR: 3.42 [1.75-6.67]), Cardiovascular diseases (OR: 3.2 [2.09-5.11]), chronic pulmonary diseases (OR: 3.21 [1.59-6.47]), and diabetes mellitus (OR: 2.5 [1.38-4.55]), resulted in higher mortality rates in hospitalized COVID-19 children. Fever (41%), cough (36%), and dyspnea (27%) were the most frequent symptoms in hospitalized children and dyspnea was associated with near three times higher mortality rate among children with COVID-19 infection (OR: 2.65 [2.13-3.29]). CONCLUSION: Iran has relatively high COVID-19 mortality in hospitalized children. Pediatricians should consider children presenting with dyspnea, infants≺ 1 year and children with underlying co-morbidities, as high-risk groups for hospitalization, ICU admission, and death. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-021-03030-2.
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spelling pubmed-86606552021-12-10 Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran Madani, Sedigheh Shahin, Sarvenaz Yoosefi, Moein Ahmadi, Naser Ghasemi, Erfan Koolaji, Sogol Mohammadi, Esmaeil Mohammadi Fateh, Sahar Hajebi, Amirali Kazemi, Ameneh Pakatchian, Erfan Rezaei, Negar Jamshidi, Hamidreza Larijani, Bagher Farzadfar, Farshad BMC Pediatr Research INTRODUCTION: COVID-19 clinical course, effective therapeutic regimen, and poor prognosis risk factors in pediatric cases are still under investigation and no approved vaccinehas been introduced for them. METHODS: This cross-sectional study evaluated different aspect of COVID-19 infection in hospitalized COVID-19 positive children (≺18 years oldwith laboratory confirmed COVID-19 infection, using the national COVID-19 registry for all admitted COVID-19 positive cases from February 19 until November 13,2020, in Iran. RESULTS: We evaluated 6610 hospitalized children. Fifty-four percent (3268) were male and one third of them were infants younger than 1 year. Mortality rate in total hospitalized children was 5.3% and in children with underlying co-morbidities (14.4%) was significantly higher (OR: 3.6 [2.7-4.7]). Chronic kidney disease (OR: 3.42 [1.75-6.67]), Cardiovascular diseases (OR: 3.2 [2.09-5.11]), chronic pulmonary diseases (OR: 3.21 [1.59-6.47]), and diabetes mellitus (OR: 2.5 [1.38-4.55]), resulted in higher mortality rates in hospitalized COVID-19 children. Fever (41%), cough (36%), and dyspnea (27%) were the most frequent symptoms in hospitalized children and dyspnea was associated with near three times higher mortality rate among children with COVID-19 infection (OR: 2.65 [2.13-3.29]). CONCLUSION: Iran has relatively high COVID-19 mortality in hospitalized children. Pediatricians should consider children presenting with dyspnea, infants≺ 1 year and children with underlying co-morbidities, as high-risk groups for hospitalization, ICU admission, and death. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-021-03030-2. BioMed Central 2021-12-10 /pmc/articles/PMC8660655/ /pubmed/34893036 http://dx.doi.org/10.1186/s12887-021-03030-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Madani, Sedigheh
Shahin, Sarvenaz
Yoosefi, Moein
Ahmadi, Naser
Ghasemi, Erfan
Koolaji, Sogol
Mohammadi, Esmaeil
Mohammadi Fateh, Sahar
Hajebi, Amirali
Kazemi, Ameneh
Pakatchian, Erfan
Rezaei, Negar
Jamshidi, Hamidreza
Larijani, Bagher
Farzadfar, Farshad
Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran
title Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran
title_full Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran
title_fullStr Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran
title_full_unstemmed Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran
title_short Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran
title_sort red flags of poor prognosis in pediatric cases of covid-19: the first 6610 hospitalized children in iran
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660655/
https://www.ncbi.nlm.nih.gov/pubmed/34893036
http://dx.doi.org/10.1186/s12887-021-03030-2
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