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Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments

OBJECTIVE: We sought to determine if corticosteroid administration is associated with a SARS-CoV-2 nucleic acid test-positive result and to describe therapies administered to SARS-CoV-2 infected children. METHODS: We collected cross-sectional data from participants recruited in 41 pediatric emergenc...

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Autores principales: Freedman, Stephen B., Kuppermann, Nathan, Funk, Anna L., Kim, Kelly, Xie, Jianling, Tancredi, Daniel, Dalziel, Stuart R., Neuman, Mark I., Mintegi, Santiago, Plint, Amy C., Gómez-Vargas, Jessica, Finkelstein, Yaron, Ambroggio, Lilliam, Klassen, Terry P., Salvadori, Marina, Malley, Richard, Payne, Daniel C., Florin, Todd A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by Academic Pediatric Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9023083/
https://www.ncbi.nlm.nih.gov/pubmed/35462066
http://dx.doi.org/10.1016/j.acap.2022.04.006
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author Freedman, Stephen B.
Kuppermann, Nathan
Funk, Anna L.
Kim, Kelly
Xie, Jianling
Tancredi, Daniel
Dalziel, Stuart R.
Neuman, Mark I.
Mintegi, Santiago
Plint, Amy C.
Gómez-Vargas, Jessica
Finkelstein, Yaron
Ambroggio, Lilliam
Klassen, Terry P.
Salvadori, Marina
Malley, Richard
Payne, Daniel C.
Florin, Todd A.
author_facet Freedman, Stephen B.
Kuppermann, Nathan
Funk, Anna L.
Kim, Kelly
Xie, Jianling
Tancredi, Daniel
Dalziel, Stuart R.
Neuman, Mark I.
Mintegi, Santiago
Plint, Amy C.
Gómez-Vargas, Jessica
Finkelstein, Yaron
Ambroggio, Lilliam
Klassen, Terry P.
Salvadori, Marina
Malley, Richard
Payne, Daniel C.
Florin, Todd A.
author_sort Freedman, Stephen B.
collection PubMed
description OBJECTIVE: We sought to determine if corticosteroid administration is associated with a SARS-CoV-2 nucleic acid test-positive result and to describe therapies administered to SARS-CoV-2 infected children. METHODS: We collected cross-sectional data from participants recruited in 41 pediatric emergency departments (ED) in 10 countries between March 2020 and June 2021. Participants were <18 years old, had signs or symptoms of, or risk factors for acute SARS-CoV-2 infection, and had nucleic acid testing performed. To determine if SARS-CoV-2 test status was independently associated with corticosteroid administration, we used a multivariable conditional logistic regression model matched by study site to compare treatments administered based on SARS-CoV-2 test and disposition status. This analysis was repeated for the subgroup of study participants who were hospitalized. RESULTS: 30.3% (3,121/10,315) of participants were SARS-CoV-2-positive. Although remdesivir was more commonly administered to SARS-CoV-2-positive children, use was infrequent (25/3120 [0.8%] vs 1/7188 [0.01%]; P = .001). Corticosteroid use was less common among SARS-CoV-2-positive children (219/3120 [7.0%] vs 759/7190 [10.6%]; P < .001). Among hospitalized children, there were no differences in provision of inotropes, respiratory support, chest drainage or extracorporeal membrane oxygenation between groups. Corticosteroid administration was associated with age, history of asthma, wheezing, study month, hospitalization and intensive care unit admission; it was not associated with a positive SARS-CoV-2 test result overall (aOR: 0.91; 95%CI: 0.74, 1.12) or among the subgroup of those hospitalized (aOR: 1.04; 95%CI: 0.75, 1.44). CONCLUSIONS: Few disease-specific treatments are provided to SARS-CoV-2-positive children; clinical trials evaluating therapies in children are urgently needed.
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spelling pubmed-90230832022-04-22 Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments Freedman, Stephen B. Kuppermann, Nathan Funk, Anna L. Kim, Kelly Xie, Jianling Tancredi, Daniel Dalziel, Stuart R. Neuman, Mark I. Mintegi, Santiago Plint, Amy C. Gómez-Vargas, Jessica Finkelstein, Yaron Ambroggio, Lilliam Klassen, Terry P. Salvadori, Marina Malley, Richard Payne, Daniel C. Florin, Todd A. Acad Pediatr Covid-19 OBJECTIVE: We sought to determine if corticosteroid administration is associated with a SARS-CoV-2 nucleic acid test-positive result and to describe therapies administered to SARS-CoV-2 infected children. METHODS: We collected cross-sectional data from participants recruited in 41 pediatric emergency departments (ED) in 10 countries between March 2020 and June 2021. Participants were <18 years old, had signs or symptoms of, or risk factors for acute SARS-CoV-2 infection, and had nucleic acid testing performed. To determine if SARS-CoV-2 test status was independently associated with corticosteroid administration, we used a multivariable conditional logistic regression model matched by study site to compare treatments administered based on SARS-CoV-2 test and disposition status. This analysis was repeated for the subgroup of study participants who were hospitalized. RESULTS: 30.3% (3,121/10,315) of participants were SARS-CoV-2-positive. Although remdesivir was more commonly administered to SARS-CoV-2-positive children, use was infrequent (25/3120 [0.8%] vs 1/7188 [0.01%]; P = .001). Corticosteroid use was less common among SARS-CoV-2-positive children (219/3120 [7.0%] vs 759/7190 [10.6%]; P < .001). Among hospitalized children, there were no differences in provision of inotropes, respiratory support, chest drainage or extracorporeal membrane oxygenation between groups. Corticosteroid administration was associated with age, history of asthma, wheezing, study month, hospitalization and intensive care unit admission; it was not associated with a positive SARS-CoV-2 test result overall (aOR: 0.91; 95%CI: 0.74, 1.12) or among the subgroup of those hospitalized (aOR: 1.04; 95%CI: 0.75, 1.44). CONCLUSIONS: Few disease-specific treatments are provided to SARS-CoV-2-positive children; clinical trials evaluating therapies in children are urgently needed. by Academic Pediatric Association 2022 2022-04-22 /pmc/articles/PMC9023083/ /pubmed/35462066 http://dx.doi.org/10.1016/j.acap.2022.04.006 Text en Copyright © 2022 by Academic Pediatric Association. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Covid-19
Freedman, Stephen B.
Kuppermann, Nathan
Funk, Anna L.
Kim, Kelly
Xie, Jianling
Tancredi, Daniel
Dalziel, Stuart R.
Neuman, Mark I.
Mintegi, Santiago
Plint, Amy C.
Gómez-Vargas, Jessica
Finkelstein, Yaron
Ambroggio, Lilliam
Klassen, Terry P.
Salvadori, Marina
Malley, Richard
Payne, Daniel C.
Florin, Todd A.
Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments
title Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments
title_full Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments
title_fullStr Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments
title_full_unstemmed Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments
title_short Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments
title_sort corticosteroids and other treatments administered to children tested for sars-cov-2 infection in emergency departments
topic Covid-19
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9023083/
https://www.ncbi.nlm.nih.gov/pubmed/35462066
http://dx.doi.org/10.1016/j.acap.2022.04.006
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