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Characteristics and Risk Factors Associated with SARS-CoV-2 Pneumonias in Hospitalized Pediatric Patients: A Pilot
María Hernández-García1,2, Claudia Solito1, Alba Pavón Ortiz1
1Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain.
Insights
Pediatric SARS-CoV-2 pneumonia is less severe in children than adults, with prematurity and certain lab markers indicating higher risk. No specific variant increased severity in children.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Virology
Background:
- SARS-CoV-2 pneumonia presents with lower incidence and severity in children compared to adults.
- Adolescence and comorbidities are identified risk factors for severe outcomes in pediatric COVID-19.
Purpose of the Study:
- To characterize children hospitalized with SARS-CoV-2 pneumonia.
- To identify risk factors associated with disease severity.
- To compare pediatric COVID-19 cases across different SARS-CoV-2 variants.
Main Methods:
- A descriptive, retrospective study of pediatric patients (0-18 years) hospitalized between March 2020 and March 2022.
- Analysis of epidemiological, clinical, diagnostic, and therapeutic data.
- Comparison of severity markers and outcomes based on SARS-CoV-2 variants.
Main Results:
- Of 44 pediatric patients, 59% were male, 61% were over 12 years old, and 82% had comorbidities (obesity, asthma).
- Critically ill children showed anemia, lymphopenia, elevated procalcitonin, LDH, and hypoalbuminemia, with lower HDL-cholesterol.
- Prematurity was linked to ICU admission; younger age was noted during the Omicron wave, but no variant increased severity.
Conclusions:
- Pediatric patients with prematurity, anemia, lymphopenia, elevated procalcitonin, LDH, hypoalbuminemia, or low HDL-cholesterol may experience more severe SARS-CoV-2 pneumonia.
- No significant differences in severity were observed between SARS-CoV-2 variants in the pediatric population, apart from age during the Omicron wave.
Abstract:
SARS-CoV-2 pneumonia in children has a lower incidence and severity compared to adults. Risk factors are adolescence and comorbidities. Our aims were to describe the characteristics of children admitted with SARS-CoV-2 pneumonia, identify risk factors associated with severity and compare the cases according to the variant of SARS-CoV-2. This was a descriptive and retrospective study, including patients aged 0-18 years hospitalized in a tertiary-care hospital between 1 March 2020 and 1 March 2022. Epidemiological, clinical, diagnostic and therapeutic data were analyzed. Forty-four patients were admitted; twenty-six (59%) were male and twenty-seven (61%) were older than 12 years. Thirty-six (82%) had comorbidities, the most frequent of which were obesity and asthma. Seven (15.9%) patients required high-flow oxygen, eleven (25%) non-invasive ventilation and four (9.1%) conventional mechanical ventilation. In critically ill patients, higher levels of anemia, lymphopenia, procalcitonin, lactate dehydrogenase (LDH) and hypoalbuminemia and lower levels of HDL-cholesterol were detected (all p < 0.05). Prematurity (p = 0.022) was associated with intensive care unit admission. Patients were younger during the Omicron wave (p < 0.01); no variant was associated with greater severity. In conclusion, pediatric patients with a history of prematurity or with anemia, lymphopenia, elevated procalcitonin, elevated LDH levels, hypoalbuminemia and low HDL-cholesterol levels may require admission and present more severe forms. Apart from age, no notable differences between SARS-CoV-2 variant periods were found.
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