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ICU Admission, Invasive Mechanical Ventilation, and Mortality among Children and Adolescents Hospitalized for
Maria da Gloria Cruvinel Horta1, Geraldo Jose Coelho Ribeiro1, Nelson Otavio Beltrao Campos2
1Research and Health Care Management (Gerencia de Pesquisa e Atençao a Saude, GPAS), Unimed-BH, Belo Horizonte, Brazil.
Insights
COVID-19 hospitalization outcomes for young people are concerning. A study found that 26.6% of hospitalized children and adolescents experienced severe outcomes, with chronic morbidity being a key risk factor.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic significantly impacted global healthcare systems.
- Limited data exists on COVID-19 outcomes specifically in pediatric and adolescent populations.
- Understanding risk factors for severe outcomes in young people is crucial for effective healthcare management.
Purpose of the Study:
- To identify factors associated with severe outcomes in children and adolescents hospitalized with COVID-19.
- To analyze the composite outcome of intensive care unit (ICU) admission, invasive mechanical ventilation, or death.
- To assess the prevalence of these outcomes in a Brazilian private healthcare system.
Main Methods:
- Retrospective analysis of hospitalized individuals aged 21 years or younger with COVID-19.
- Inclusion criteria: COVID-19 hospitalization between February 28, 2020, and November 1, 2021.
- Primary endpoint: Composite outcome (ICU admission, mechanical ventilation, or death).
Main Results:
- 199 patients were evaluated, with a median age of 4.5 years.
- The composite outcome occurred in 26.6% of hospitalizations.
- All evaluated pre-existing co-morbidities were associated with the composite outcome.
- 27 readmissions (16 patients) occurred within 30 days post-discharge.
Conclusions:
- Hospitalized children and adolescents faced a significant risk (26.6%) of severe outcomes during their initial COVID-19 hospitalization.
- Pre-existing chronic morbidity emerged as a significant predictor for adverse outcomes in this young population.
- Further research is warranted to understand and mitigate these risks in pediatric COVID-19 cases.
Aim:
The COVID-19 pandemic devastated healthcare around the world. Data about the COVID-19 outcomes among young people are still scarce. We aim to identify factors associated with the composite outcome among children and adolescents hospitalized due to COVID-19.
Methods:
We performed a search in the database of a large Brazilian private healthcare system. Insured people aged 21 years or younger who were hospitalized due to COVID-19 from Feb/28th/2020 to Nov/1st/2021 were included. The primary endpoint was the composite outcome consisting of ICU admission, need for invasive mechanical ventilation, or death.
Results:
We evaluated 199 patients who had an index hospitalization due to COVID-19. The median monthly rate of index hospitalization was 2.7 (interquartile range [IQR], 1.6-3.9) per 100,000 clients aged 21 years or less. The median age of the patients was 4.5 years (IQR, 1.4-14.1). At the index hospitalization, the composite outcome rate was 26.6%. The composite outcome was associated with all the previous coexisting morbidities evaluated. The median follow-up was 249.0 days (IQR, 152.0-438.5). There were 27 readmissions (16 patients) within 30 days after the discharge.
Conclusions:
In conclusion, hospitalized children and adolescents had a composite outcome rate of 26.6% at the index hospitalization. Having previous chronic morbidity was associated with the composite.
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