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Characteristics and outcomes of children with SARS-CoV-2 respiratory failure: a matched cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年5月13日

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  • Ira M. Cheifetz,
  • Onella S. Dawkins-Henry,
  • Michele Kong,
  • Lisa A. Asaro,
  • Natalie Napolitano,
  • Mallory A. Perry-Eaddy,
  • Peter M. Luckett,
  • Martin C. J. Kneyber,
  • David Wypij,
  • Martha A. Q. Curley,
  • Palen Mallory,
  • Nadir Yehya,
  • Erin Kreml,
  • Adam Schwartz,
  • Kari Wellnitz,
  • Katherine Clement,
  • Timothy Cornell,
  • Emilie Henry,
  • Laurie Lee,
  • Sidharth Mahapatra,
  • Melissa B. Porter,
  • Courtney Rowan,
  • Neal J. Thomas,
  • Shan Ward,
  • Himanshu Aneja,
  • Jessica Asencio,
  • Jasmine Dowell,
  • Kim McMahon,
  • Matei Petrescu

摘要

Background

There are limited data on the clinical characteristics and outcomes of critically ill children requiring mechanical ventilation for SARS-CoV-2 acute respiratory failure.

Methods

We performed a multicentre prospective matched cohort study of mechanically ventilated paediatric patients aged 2 weeks to 18 years with confirmed SARS-CoV-2 acute respiratory failure, excluding Multisystem Inflammatory Syndrome. Cases were matched at 1:4 ratio to a pre COVID-19 pandemic paediatric cohort. Age, paediatric acute respiratory distress (PARDS) category, and organ dysfunction on days 0–1 of mechanical ventilation were used to match patients.

Results

Of 53 COVID-19 subjects, 60% were male, median age was 11.1 years (interquartile range 1.6–15.7), and 89% had moderate to severe PARDS on days 0–1. Compared to 195 matched controls, more children with COVID-19 were obese, cognitively or functionally impaired at baseline, Hispanic/Latino, and had pre-existing respiratory and neurologic conditions. Observed 28-day mortality was not different, but the COVID-19 cohort experienced fewer ventilator-free days and, among survivors, longer PICU stays. More COVID-19 patients were transitioned to extracorporeal membrane oxygenation.

Conclusions

Children with COVID-19 related acute respiratory failure suffered disproportionately from chronic conditions and required more critical care support than children with acute respiratory failure without SARS-CoV-2 related infection.