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COVID-19 in Pediatric Patients with and Without Immunocompromised
Alireza Nateghian1, Mahgol Sadeghian2, Rozita Hosseini Shamsabadi1
1Department of Pediatrics, School of Medicine, Hazrat-e Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.
Insights
Children with immunocompromised conditions experienced more severe COVID-19 symptoms, including higher mortality and intubation rates. This highlights the need for specialized care for immunocompromised pediatric patients during the pandemic.
Area of Science:
- Immunology
- Infectious Diseases
- Pediatrics
Background:
- The impact of Coronavirus Disease 2019 (COVID-19) on immunocompromised children is a critical research area.
- Understanding COVID-19's effects on this vulnerable group is essential for public health.
- Previous studies have not fully detailed the comparative clinical outcomes in pediatric COVID-19 cases based on immune status.
Purpose of the Study:
- To compare the symptoms, clinical progression, and outcomes of COVID-19 in pediatric patients with and without immunocompromised conditions.
- To identify specific risk factors and clinical characteristics associated with severe COVID-19 in immunocompromised children.
- To inform clinical management and public health strategies for pediatric COVID-19 patients.
Main Methods:
- A retrospective cohort study was conducted involving 200 pediatric patients (≤18 years) with confirmed COVID-19.
- Patients were divided into two groups: 100 immunocompromised and 100 non-immunocompromised children.
- Statistical analyses included chi-square, Fisher's exact, independent t-tests, and Mann-Whitney U tests to compare groups (P < 0.05 considered significant).
Main Results:
- Immunocompromised children exhibited higher rates of cough, respiratory distress, vomiting, and diarrhea, alongside lower oxygen saturation.
- These patients experienced significantly higher mortality (P=0.018), intubation rates (P=0.018), and longer hospital stays (P<0.001).
- Infants (<1 year) with immunocompromise faced the highest risk, with 50% mortality and 66.7% intubation rates.
Conclusions:
- Pediatric COVID-19 patients with immunocompromised conditions face significantly more severe disease, higher mortality, and prolonged hospitalization.
- The findings underscore the urgent need for tailored management strategies for immunocompromised children infected with COVID-19.
- This research emphasizes the critical importance of protecting and prioritizing immunocompromised pediatric populations during infectious disease outbreaks.
Background:
The effect of Coronavirus Disease 2019 (COVID-19) on pediatric patients with immunodeficiency is a major research priority. .. The objective of this investigation was to perform a comparative assessment of the symptomatology, clinical course, and endpoints of COVID-19 infection in children patients with and without immunocompromised conditions.
Methods:
This retrospective cohort study included children aged ≤18 years with confirmed COVID-19 infection, diagnosed via RT-PCR (Reverse Transcription Polymerase Chain Reaction) testing, who were admitted to Ali Asghar Children's Hospital in Tehran, Iran, from February 20, 2020, to February 20, 2023. A total of 200 patients were included, comprising 100 immunocompromised and 100 non-immunocompromised children, selected from hospital records. Categorical variables were compared using the chi-square or Fisher's exact test, and continuous variables were compared using the independent t-test or Mann-Whitney U test, based on their normality as determined by the Kolmogorov-Smirnov test. A P-value < 0.05 was considered statistically significant.
Results:
The average age of patients with immunocompromised conditions was 76.48 ± 58.33 months, while those without such conditions had a mean age of 38.02 ± 44.47 months. Children with immunocompromised conditions had lower exposure to positive contacts (P = 0.010) and exhibited higher rates of cough (P < 0.001), respiratory distress (P = 0.001), vomiting (P = 0.024), diarrhea (P < 0.001), and lower oxygen saturation (P = 0.001). Additionally, they demonstrated significantly higher rates of mortality (P = 0.018), intubation (P = 0.018), and longer hospital stays (P < 0.001). An age-stratified analysis revealed that patients (<1 year) with immunocompromise were at the highest risk, with mortality and intubation rates of 50% and 66.7%, respectively, compared to 0% and 10% in immunocompetent infants.
Conclusion:
Pediatric patients with immunocompromised conditions who contracted COVID-19 experienced more severe symptoms than their non-immunocompromised counterparts. These patients had higher mortality and intubation rates, as well as longer hospital stays. This increased risk underscores the necessity for specialized management strategies tailored to this vulnerable population.
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