Survival analysis and mortality predictors of COVID-19 in Moroccan children: A multicenter study

Although COVID-19 in children is benign, it has revealed a critical vulnerability in the neonatal population. This study aimed to identify the mortality predictors and determinants of survival in children affected by COVID-19 in the Marrakech-Safi (RMS) region of Morocco.

This was a retrospective, multicenter cohort study conducted among children hospitalized with COVID-19 between March 2020 and December 2021 in two RMS hospitals. All patients aged under 15 years with confirmed SARS-CoV-2 infection were included; incomplete files, misdiagnoses, and transferred patients were excluded. Overall survival was assessed using the Kaplan-Meier curve, associations were examined with the log-rank test, and predictors were identified using Cox proportional hazards regression models.

A total of 167 children were identified, including 52.7% females and 20.4% (n = 34) neonates. The death rate was 4.79%, with a mean overall survival of 40.9 days. The analysis identified thrombocytopenia (adjusted hazard ratio [aHR] = 87.07, 95% confidence interval [CI]: 59.85-126.77, P <0.001), cardiopathy (aHR = 34.95, 95% CI: 3.41-358.23, P = 0.003), maternal-fetal infection (aHR = 57.65, 95% CI : 4.00-831.62, P = 0.003), and the presence of respiratory distress (aHR = 48.37, 95% CI: 3.30-709.01, P = 0.005) as major mortality predictors.

Implementing rapid intervention and preventive medicine strategies is essential to reducing morbidity and mortality in pediatric populations during future public health emergencies.