Clinical spectrum of COVID-19 and risk factors associated with severity in Spanish children

We aimed to identify the spectrum of disease in children with COVID-19, and the risk factors for admission in paediatric intensive care units (PICUs). We conducted a multicentre, prospective study of children with SARS-CoV-2 infection in 76 Spanish hospitals. We included children with COVID-19 or mu...

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Detalles Bibliográficos
Autores: Tagarro, A, Cobos-Carrascosa, E, Villaverde, S, Sanz-Santaeufemia, FJ, Grasa, C, Soriano-Arandes, A, Hernanz, A, Navarro, ML, Pino, R, Epalza, C, Batista, R, Rizo, J, Iglesias-Bouzas, MI, Rodriguez-Molino, P, Villanueva-Medina, S, Carrasco-Colom, J, Alonso-Cadenas, JA, Mellado, MJ, Herrero, B, Melendo, S, De la Torre, M, Calleja, L, Calvo, C, Urretavizcaya-Martinez, M, Astigarraga, I, Menasalvas, A, Penin, M, Neth, O, Berzosa, A, De Ceano-Vivas, M, Vidal, P, Romero, I, Gonzalez, R, Garcia, ML, Mesa, JM, Ballesteros, A, Bernardino, M, Moraleda, C
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p12762
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/12762
Access Level:acceso abierto
Palabra clave:COVID-19
SARS-CoV-2
Children
Clinical phenotypes
MIS-C
Severity
Descripción
Sumario:We aimed to identify the spectrum of disease in children with COVID-19, and the risk factors for admission in paediatric intensive care units (PICUs). We conducted a multicentre, prospective study of children with SARS-CoV-2 infection in 76 Spanish hospitals. We included children with COVID-19 or multi-inflammatory syndrome (MIS-C) younger than 18 years old, attended during the first year of the pandemic. We enrolled 1200 children. A total of 666 (55.5%) were hospitalised, and 123 (18.4%) required admission to PICU. Most frequent major clinical syndromes in the cohort were mild syndrome (including upper respiratory tract infection and flu-like syndrome, skin or mucosae problems and asymptomatic), 44.8%; bronchopulmonary syndrome (including pneumonia, bronchitis and asthma flare), 18.5%; fever without a source, 16.2%; MIS-C, 10.6%; and gastrointestinal syndrome, 10%. In hospitalised children, the proportions were 28.5%, 25.7%, 16.5%, 19.1% and 10.2%, respectively. Risk factors associated with PICU admission were age in months (OR: 1.007; 95% CI 1.004 to 1.01), MIS-C (OR: 14.4, 95% CI 8.9 to 23.8), chronic cardiac disease (OR: 4.8, 95% CI 1.8 to 13), asthma or recurrent wheezing (OR: 2.5, 95% CI 1.2 to 5.2) and after excluding MIS-C patients, moderate/severe liver disease (OR: 8.6, 95% CI 1.6 to 47.6). However, asthmatic children were admitted into the PICU due to MIS-C or pneumonia, not due to asthma flare. Conclusion: Hospitalised children with COVID-19 usually present as one of five major clinical phenotypes of decreasing severity. Risk factors for PICU include MIS-C, elevation of inflammation biomarkers, asthma, moderate or severe liver disease and cardiac disease.

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