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[Survival in pediatric patients with pneumonia in coronavirus disease 2019]
Efrén Murillo-Zamora1, Alicia Jiménez-Álvarez2
1Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 19, Departamento de Epidemiología. Colima, Colima, México.
Insights
Children and adolescents with COVID-19 pneumonia face survival challenges. Immunosuppression history significantly increases the risk of fatal outcomes in these young patients.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- Limited evidence exists on prognostic factors for coronavirus disease 2019 (COVID-19) pneumonia in children and adolescents.
- Pneumonia is a significant complication of COVID-19 in pediatric populations.
Purpose of the Study:
- To determine the survival rates of hospitalized children and adolescents with COVID-19 related pneumonia.
- To identify prognostic factors associated with adverse outcomes in this cohort.
Main Methods:
- A cohort study was conducted in Mexico analyzing data from hospitalized pediatric patients with COVID-19 pneumonia.
- Kaplan-Meier survival analysis and Cox proportional-hazards regression were employed to assess survival functions and risk factors.
Main Results:
- The study included 1423 patients with a mortality rate of 13.7 per 1000 person-days.
- Overall survival at the end of hospital stay was 69.3%.
- History of immunosuppression was a significant risk factor for fatal outcomes (Hazard Ratio = 2.70).
Conclusions:
- This study provides a comprehensive characterization of survival in a large cohort of pediatric patients with COVID-19 pneumonia.
- Minors with a history of immunosuppression and pneumonia face a substantially increased risk of mortality.
Background:
A segment of children and adolescents with coronavirus disease 2019 (COVID-19) develops pneumonia and published evidence regarding its prognostic factors in this specific population is scarce.
Objective:
To characterize the survival of children and adolescents hospitalized for pneumonia related to COVID-19, as well as to evaluate prognostic factors for disease's outcomes.
Material And Methods:
A cohort study was performed in Mexico and data from hospitalized children and adolescents with COVID-19 related pneumonia were analyzed. We used the Kaplan-Meier method to estimate survival functions and 95% confidence intervals (95% CI), as well as Cox proportional-hazards regressions to evaluate the association of the evaluated exposures with the outcomes of disease.
Results:
A total of 1423 patients were recruited for a follow-up of 15,188 person-days and the overall rate of in-hospital mortality (n = 208) was 13.7 per 1000 person-days. The survival function was 96.5% (95% CI 95.2-97.4%) and 69.3% (95% CI 63.9-74.0) of hospital stay, respectively. In multiple analysis, the history of immunosuppression was associated with an increased risk of a fatal outcome (hazard ratio [HR] = 2.70, IC 95% 1.38-5.30).
Conclusions:
We characterized the survival of a large cohort of children and adolescents with COVID-19 related pneumonia. The presented findings suggest that minors with a history of immunosuppression and pneumonia have an increased risk of fatal outcome.
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