Related Experiment Video
Updated: Jul 25, 2025
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
COVID-19 in Pediatric Intensive Care Units in Poland, PAPITCO-19 Study (Polish Analysis of PICU Trends during
Maria Damps1, Elżbieta Byrska-Maciejasz2, Małgorzata Kowalska3
1Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Insights
Children with comorbidities face a higher risk of severe COVID-19. Respiratory failure, mechanical ventilation, and high AST levels indicate a poor prognosis in pediatric intensive care unit patients.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Respiratory medicine
Background:
- COVID-19 affects children, with a small percentage requiring intensive care.
- Comorbidities increase the risk of severe disease and respiratory failure in pediatric COVID-19 cases.
Purpose of the Study:
- To analyze epidemiological and laboratory parameters of children admitted to pediatric intensive care units (PICUs) for severe SARS-CoV-2 infection.
- To identify factors associated with mortality and prognosis in critically ill children with COVID-19.
Main Methods:
- Retrospective multi-center study of children with confirmed SARS-CoV-2 admitted to PICUs (November 2020 - August 2021).
- Analysis of epidemiological data, laboratory parameters, and outcomes (survival/death).
- Utilized Lung Injury Score and Pediatric Sequential Organ Failure Assessment (pSOFA).
Main Results:
- 45 pediatric patients analyzed; overall mortality was 40%.
- Significant differences between survivors and non-survivors were observed in respiratory parameters.
- Elevated AST levels correlated with disease severity (p=0.028).
- Mechanical ventilation patients with better outcomes had higher initial oxygen index and lower pSOFA and AST levels.
Conclusions:
- Comorbidities are a key risk factor for severe COVID-19 in children, mirroring adult trends.
- Progressive respiratory failure, need for mechanical ventilation, and persistently high AST levels are poor prognostic indicators.
Background:
Children suffering from COVID-19 constitute about 10% of the entire population infected with the virus. In most of them, we observe asymptomatic or mild courses; however, about 1% of affected children require a stay in a paediatric intensive care unit (PICU) due to the course of the disease becoming severely life-threatening. The risk of respiratory failure, as with adults, is associated with the coexistence of concomitant diseases. The aim of our study was to analyse patients admitted to PICUs due to the severe course of their SARS-CoV-2 infection. We studied epidemiological and laboratory parameters, as well as the endpoint (survival or death).
Methods:
A retrospective multi-centre study, the analysis covered all children with a confirmed diagnosis of SARS-CoV-2 virus infection who were admitted to PICUs in the period from November 2020 to August 2021. We studied epidemiological and laboratory parameters, as well as the endpoint (survival or death).
Results:
The study analysed 45 patients (0.075% of all children hospitalised in Poland due to COVID-19 at that time). Mortality calculated in the entire study group was 40% (n = 18). Statistically significant differences between the compared groups (survived and died) concerned the parameters of the respiratory system. Lung Injury Score and the Paediatric Sequential Organ Failure Assessment were used. A significant correlation between disease severity and the patient's prognosis was shown by the liver function parameter AST (p = 0.028). During the analysis of patients requiring mechanical ventilation and assuming survival as the primary outcome, a significantly higher oxygen index on the first day of hospitalisation, lower pSOFA scores and lower AST levels (p: 0.007; 0.043; 0.020; 0.005; 0.039, respectively) were found.
Conclusions:
As with adults, children with comorbidities are most frequently at risk of severe SARS-CoV-2 infection. Increasing symptoms of respiratory failure, the need for mechanical ventilation and persistently high values of aspartate aminotransferase are indicators of poor prognosis.
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:21Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:30Acute Respiratory Failure-III
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...