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Mortality risk factors among hospitalized children with severe pertussis

Tingting Shi1, Ling Wang2, Shuling Du3

  • 1Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120, Guangdong, China.

BMC Infectious Diseases
|October 13, 2021
PubMed

Insights

Severe pertussis is a significant threat to infants, with high mortality rates in those under six weeks old. High white blood cell counts and pulmonary hypertension are key risk factors for death in severe pertussis cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Severe pertussis poses a critical threat to hospitalized infants, often necessitating intensive care.
  • Mortality in severe pertussis can result from disease progression or complications.

Purpose of the Study:

  • To identify mortality risk factors in children hospitalized with severe pertussis.
  • To inform potential adjustments in infant immunization schedules.

Main Methods:

  • Retrospective analysis of medical records for 144 hospitalized children with severe pertussis.
  • Data collected from Guangzhou Women and Children's Medical Centre (January 2016 - December 2019).

Main Results:

  • The majority of severe pertussis cases (90.3%) occurred in infants under six months old.
  • Overall mortality was 34.2%, with 76.9% of deaths in infants younger than six weeks.
  • Independent risk factors for mortality included a white blood cell count >70.0 × 10^9/L and pulmonary hypertension.

Conclusions:

  • Severe pertussis predominantly affects infants under three months old, with a high mortality rate (34.2%).
  • Infants under six weeks are particularly vulnerable, accounting for most deaths.
  • Recommendations include advancing the first diphtheria-tetanus-pertussis (DTP) vaccine dose to two months or even six weeks of age.
Abstract

Keywords:
ChildrenPediatric intensive care unitPertussisRisk factor

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