The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has collapsed health systems worldwide. In adults, the virus causes severe acute respiratory distress syndrome (ARDS), while in children the disease seems to be milder, although a severe multisystem inflammatory syndrome (M...

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Autores: Girona Alarcón, Mònica, Bobillo Pérez, Sara, Solé Ribalta, Anna, Hernández Platero, Lluisa, Guitart, Carmina, Suárez, Ricardo, Balaguer Gargallo, Mònica, Cambra Lasaosa, Francisco José, Jordán García, Iolanda, KIDS-Corona study group, Kids Corona Platform
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/177145
Acceso en línea:https://hdl.handle.net/2445/177145
Access Level:acceso abierto
Palabra clave:COVID-19
Marcadors bioquímics
Insuficiència respiratòria
Biochemical markers
Respiratory insufficiency
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spelling The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unitGirona Alarcón, MònicaBobillo Pérez, SaraSolé Ribalta, AnnaHernández Platero, LluisaGuitart, CarminaSuárez, RicardoBalaguer Gargallo, MònicaCambra Lasaosa, Francisco JoséJordán García, IolandaKIDS-Corona study groupKids Corona PlatformCOVID-19Marcadors bioquímicsInsuficiència respiratòriaCOVID-19Biochemical markersRespiratory insufficiencyBackground: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has collapsed health systems worldwide. In adults, the virus causes severe acute respiratory distress syndrome (ARDS), while in children the disease seems to be milder, although a severe multisystem inflammatory syndrome (MIS-C) has been described. The aim was to describe and compare the characteristics of the severe COVID-19 disease in adults and children. Methods: This prospective observational cohort study included the young adults and children infected with SARS-CoV-2 between March-June 2020 and admitted to the paediatric intensive care unit. The two populations were analysed and compared focusing on their clinical and analytical characteristics and outcomes. Results: Twenty patients were included. There were 16 adults (80%) and 4 children (20%). No mortality was recorded. All the adults were admitted due to ARDS. The median age was 32 years (IQR 23.3-41.5) and the most relevant previous pathology was obesity (n = 7, 43.7%). Thirteen (81.3%) needed mechanical ventilation, with a median PEEP of 13 (IQR 10.5-14.5). Six (37.5%) needed inotropic support due to the sedation. Eight (50%) developed a healthcare-associated infection, the most frequent of which was central line-associated bloodstream infection (n = 7, 71.4%). One patient developed a partial pulmonary thromboembolism, despite him being treated with heparin. All the children were admitted due to MIS-C. Two (50%) required mechanical ventilation. All needed inotropic support, with a median vasoactive-inotropic score of 27.5 (IQR 17.5-30). The difference in the inotropic requirements between the two populations was statistically significant (37.5% vs. 100%, p < 0.001). The biomarker values were higher in children than in adults: mid-regional pro-adrenomedullin 1.72 vs. 0.78 nmol/L (p = 0.017), procalcitonin 5.7 vs. 0.19 ng/mL (p = 0.023), and C-reactive protein 328.2 vs. 146.9 mg/L (p = 0.005). N-terminal pro-B-type natriuretic peptide and troponins were higher in children than in adults (p = 0.034 and p = 0.039, respectively). Conclusions: Adults and children had different clinical manifestations. Adults developed severe ARDS requiring increased respiratory support, whereas children presented MIS-C with greater inotropic requirements. Biomarkers could be helpful in identifying susceptible patients, since they might change depending on the clinical features.BioMed Central2021202120202021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion8 p.application/pdfhttps://hdl.handle.net/2445/177145Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1186/s12879-021-05786-5BMC Infectious Diseases, 2020, vol. 21, num. 1, p. 87https://doi.org/10.1186/s12879-021-05786-5cc-by (c) Girona Alarcón, Mónica et al., 2020https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1771452026-05-29T05:05:01Z
dc.title.none.fl_str_mv The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
title The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
spellingShingle The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
Girona Alarcón, Mònica
COVID-19
Marcadors bioquímics
Insuficiència respiratòria
COVID-19
Biochemical markers
Respiratory insufficiency
title_short The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
title_full The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
title_fullStr The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
title_full_unstemmed The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
title_sort The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit
dc.creator.none.fl_str_mv Girona Alarcón, Mònica
Bobillo Pérez, Sara
Solé Ribalta, Anna
Hernández Platero, Lluisa
Guitart, Carmina
Suárez, Ricardo
Balaguer Gargallo, Mònica
Cambra Lasaosa, Francisco José
Jordán García, Iolanda
KIDS-Corona study group
Kids Corona Platform
author Girona Alarcón, Mònica
author_facet Girona Alarcón, Mònica
Bobillo Pérez, Sara
Solé Ribalta, Anna
Hernández Platero, Lluisa
Guitart, Carmina
Suárez, Ricardo
Balaguer Gargallo, Mònica
Cambra Lasaosa, Francisco José
Jordán García, Iolanda
KIDS-Corona study group
Kids Corona Platform
author_role author
author2 Bobillo Pérez, Sara
Solé Ribalta, Anna
Hernández Platero, Lluisa
Guitart, Carmina
Suárez, Ricardo
Balaguer Gargallo, Mònica
Cambra Lasaosa, Francisco José
Jordán García, Iolanda
KIDS-Corona study group
Kids Corona Platform
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Marcadors bioquímics
Insuficiència respiratòria
COVID-19
Biochemical markers
Respiratory insufficiency
topic COVID-19
Marcadors bioquímics
Insuficiència respiratòria
COVID-19
Biochemical markers
Respiratory insufficiency
description Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has collapsed health systems worldwide. In adults, the virus causes severe acute respiratory distress syndrome (ARDS), while in children the disease seems to be milder, although a severe multisystem inflammatory syndrome (MIS-C) has been described. The aim was to describe and compare the characteristics of the severe COVID-19 disease in adults and children. Methods: This prospective observational cohort study included the young adults and children infected with SARS-CoV-2 between March-June 2020 and admitted to the paediatric intensive care unit. The two populations were analysed and compared focusing on their clinical and analytical characteristics and outcomes. Results: Twenty patients were included. There were 16 adults (80%) and 4 children (20%). No mortality was recorded. All the adults were admitted due to ARDS. The median age was 32 years (IQR 23.3-41.5) and the most relevant previous pathology was obesity (n = 7, 43.7%). Thirteen (81.3%) needed mechanical ventilation, with a median PEEP of 13 (IQR 10.5-14.5). Six (37.5%) needed inotropic support due to the sedation. Eight (50%) developed a healthcare-associated infection, the most frequent of which was central line-associated bloodstream infection (n = 7, 71.4%). One patient developed a partial pulmonary thromboembolism, despite him being treated with heparin. All the children were admitted due to MIS-C. Two (50%) required mechanical ventilation. All needed inotropic support, with a median vasoactive-inotropic score of 27.5 (IQR 17.5-30). The difference in the inotropic requirements between the two populations was statistically significant (37.5% vs. 100%, p < 0.001). The biomarker values were higher in children than in adults: mid-regional pro-adrenomedullin 1.72 vs. 0.78 nmol/L (p = 0.017), procalcitonin 5.7 vs. 0.19 ng/mL (p = 0.023), and C-reactive protein 328.2 vs. 146.9 mg/L (p = 0.005). N-terminal pro-B-type natriuretic peptide and troponins were higher in children than in adults (p = 0.034 and p = 0.039, respectively). Conclusions: Adults and children had different clinical manifestations. Adults developed severe ARDS requiring increased respiratory support, whereas children presented MIS-C with greater inotropic requirements. Biomarkers could be helpful in identifying susceptible patients, since they might change depending on the clinical features.
publishDate 2020
dc.date.none.fl_str_mv 2020
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/177145
url https://hdl.handle.net/2445/177145
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s12879-021-05786-5
BMC Infectious Diseases, 2020, vol. 21, num. 1, p. 87
https://doi.org/10.1186/s12879-021-05786-5
dc.rights.none.fl_str_mv cc-by (c) Girona Alarcón, Mónica et al., 2020
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Girona Alarcón, Mónica et al., 2020
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 8 p.
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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