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Published on: December 19, 2020
Characteristics of Hospitalized Children With SARS-CoV-2 in the New York City Metropolitan Area
Sourabh Verma1,2, Rishi Lumba3, Heda M Dapul3,2
1Departments of Pediatrics and sourabh.verma@nyulangone.org.
Insights
Hospitalized children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in NYC faced critical care needs, especially those with comorbidities like obesity and asthma. Renal dysfunction also predicted critical care admission.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a global pandemic in 2020.
- Pediatric hospitalizations due to SARS-CoV-2 required characterization to inform clinical management.
- Understanding risk factors for severe disease in children is crucial for public health strategies.
Purpose of the Study:
- To describe the clinical characteristics of hospitalized children diagnosed with SARS-CoV-2.
- To identify risk factors associated with critical care admission and respiratory support needs in pediatric patients.
- To analyze the impact of comorbidities and renal dysfunction on disease severity.
Main Methods:
- A multicenter, retrospective cohort study was conducted.
- Included 82 hospitalized children (0-21 years) with confirmed SARS-CoV-2 infection.
- Patients were analyzed based on care unit, age, and need for respiratory support.
Main Results:
- 28% of hospitalized children required critical care, and 35% needed respiratory support (9% mechanical ventilation).
- Comorbidities, particularly obesity and asthma, were linked to increased critical care and respiratory support.
- Renal dysfunction at presentation was associated with higher critical care admission rates.
Conclusions:
- Children with comorbidities, especially obesity and asthma, face a higher risk of severe SARS-CoV-2 disease.
- Renal dysfunction is a significant predictor of critical care needs in pediatric SARS-CoV-2 patients.
- All studied pediatric patients survived hospitalization, highlighting the importance of timely medical intervention.
Objectives:
To describe the characteristics of hospitalized children with severe acute respiratory syndrome coronavirus 2 in New York City metropolitan area.
Patients And Methods:
This was a multicenter, retrospective cohort study at 4 hospitals comprising 82 hospitalized children (0-21 years) who tested positive for severe acute respiratory syndrome coronavirus 2 after symptoms and risk screening between March 1 and May 10, 2020. We subdivided patients on the basis of their admission to acute or critical care units and by age groups. Further subanalyses were performed between patients requiring respiratory support or no respiratory support.
Results:
Twenty-three (28%) patients required critical care. Twenty-nine (35%) patients requiring respiratory support, with 9% needing mechanical ventilation, and 1 required extracorporeal support. All patients survived to discharge. Children with any comorbidity were more likely to require critical care (70% vs 37%, P = .008), with obesity as the most common risk factor for critical care (63% vs 28%, P = .02). Children with asthma were more likely to receive respiratory support (28% vs 8%, P = .02), with no difference in need for critical care (P = .26). Children admitted to critical care had higher rates of renal dysfunction at presentation (43% vs 10%, P = .002).
Conclusions:
Children with comorbidities (obesity and asthma in particular) were at increased risk for critical care admission and/or need for respiratory support. Children with renal dysfunction at presentation were more likely to require critical care.
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