Pediatric patients with COVID-19 admitted to a PICU in Southern Brazil, excluding MIS-C

OBJECTIVE: To describe pediatric patients admitted to a PICU with a diagnosis of COVID-19 and to compare some variables in relation to severely ill patients and critically ill children, excluding patients with MIS-C. METHOD: Retrospective case series of patients aged 24 days to 15 years with a diagnosis of COVID-19 admitted to a PICU from April 1, 2020, to April 1, 2021. We describe data regarding epidemiological characteristics, clinical manifestations, laboratory, and imaging tests, treatment, and outcome. We also divided the patients into two groups: severely ill patients and critically ill patients (those who required invasive mechanical ventilation (IMV), non-invasive ventilation or shock), and we compared some variables to determine possible predictors of greater severity. RESULTS: 32 children were admitted with severe COVID-19; 20 of them were considered critical. The median age was 2 years. Of the patients, 50% were male and 81% had comorbidities, and 44% had 3 or more comorbidities. Respiratory failure was the main cause of hospitalization. Fifty-six percent required IMV, and 37% used vasoactive drugs. Bacterial or viral co-infection occurred in 41%. A total of 81% of our patients received antimicrobials, 53% patients received low-dose corticoids, and 25% received enoxaparin. Patients with 3 or more comorbidities were significantly more frequent in the critically ill group. CONCLUSION: Most of the children admitted to PICU had comorbidities, and children under 1 year of age made up almost half of the sample. In our study, the presence of three or more comorbidities was more frequent in pediatric patients with critical COVID-19.