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Published on: December 7, 2018
SARS-CoV-2 infection in technology-dependent children: a multicenter case series
Joan Robinson1, Tammie Dewan2, Shaun K Morris3
1Department of Pediatrics, University of Alberta, 3-556ECHA, Edmonton, AB, T6G 1C9, Canada. jr3@ualberta.ca.
Insights
Children with technology dependence (TD) face higher COVID-19 hospitalization risks. However, those without end-stage conditions survived hospitalization, highlighting the importance of baseline health status for COVID-19 outcomes in pediatric patients.
Area of Science:
- Pediatric infectious diseases
- Critical care medicine
- Epidemiology
Background:
- Technology dependence (TD) in children presents unique challenges during acute illness.
- Understanding the impact of SARS-CoV-2 on vulnerable pediatric populations is crucial.
Purpose of the Study:
- To describe the clinical course and outcomes of children with technology dependence (TD) hospitalized with SARS-CoV-2 infection.
- To assess the risk factors and severity of COVID-19 in this specific pediatric cohort.
Main Methods:
- A multi-center study involving 17 pediatric hospitals across Canada, Iran, and Costa Rica.
- Inclusion criteria: children up to 17 years old admitted with SARS-CoV-2 detection between February 1, 2020, and May 31, 2021.
- Data collection focused on demographics, clinical course, and outcomes for children with TD.
Main Results:
- Out of 691 children, 42 (6%) had TD, with varying dependencies (feeding tubes, oxygen, ventilation, tracheostomy).
- Three cases had incidental SARS-CoV-2 infection; two children with end-stage conditions died.
- Of the remaining 37, 16 (43%) required increased respiratory support due to COVID-19; 21 (57%) did not. All survivors were discharged home.
Conclusions:
- Children with TD demonstrate an elevated risk for COVID-19 hospitalization.
- Despite increased hospitalization risk, children with TD and without end-stage chronic conditions had favorable outcomes, surviving to discharge.
Purpose:
The objective of this study was to describe the clinical course and outcomes in children with technology dependence (TD) hospitalized with SARS-CoV-2 infection.
Methods:
Seventeen pediatric hospitals (15 Canadian and one each in Iran and Costa Rica) included children up to 17 years of age admitted February 1, 2020, through May 31, 2021, with detection of SARS-CoV-2. For those with TD, data were collected on demographics, clinical course and outcome.
Results:
Of 691 children entered in the database, 42 (6%) had TD of which 22 had feeding tube dependence only, 9 were on supplemental oxygen only, 3 had feeding tube dependence and were on supplemental oxygen, 2 had a tracheostomy but were not ventilated, 4 were on non-invasive ventilation, and 2 were on mechanical ventilation prior to admission. Three of 42 had incidental SARS-CoV-2 infection. Two with end-stage underlying conditions were transitioned to comfort care and died. Sixteen (43%) of the remaining 37 cases required increased respiratory support from baseline due to COVID-19 while 21 (57%) did not. All survivors were discharged home.
Conclusion:
Children with TD appear to have an increased risk of COVID-19 hospitalization. However, in the absence of end-stage chronic conditions, all survived to discharge.
