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Experience in COVID-19 in hospitalized patients in pediatric critical units during pandemic period

Experiencia en COVID-19 en pacientes hospitalizados en unidades de paciente crítico pediátrico durante el periodo pandémico

dc.contributoren-US
dc.contributorRama de Cuidados intensivos Pediátricos, Sociedad Chilena de Pediatríaes-ES
dc.creatorWegner Araya, Adriana
dc.creatorCéspedes Fernández, Pamela
dc.creatorAstudillo Paredes, Patricio
dc.creatorDiettes González, Adriana
dc.creatorDíaz Rubio, Franco
dc.creatorScheu Goncalves, Christian
dc.creatorChauriye Kuncar, Verónica
dc.creatorGaete Amenábar, Tomás
dc.creatorZamora Astudillo, Marta
dc.creatorAcuña Aguirre, Carlos
dc.creatorDrago Thibaut, Michele
dc.creatorMonreal Eloaiza, Víctor
dc.creatorLapadula Amelina, Michelangelo
dc.creatorPietroboni Fuster, Pietro
dc.creatorVarela Ortiz, Javier
dc.creatorGallardo Martínez, Alena
dc.creatorScheuch Ruiz, Karin
dc.creatorManen Chinchón, Andrés
dc.creatorVillarroel Carreño, María José
dc.creatorVerscheure Peralta, Felipe
dc.creatorMaldonado Valenzuela, Blanca
dc.creatorMeyer Flores, Matías
dc.date2023-10-18
dc.date.accessioned2023-11-29T13:41:34Z
dc.date.available2023-11-29T13:41:34Z
dc.identifierhttp://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4527
dc.identifier10.32641/andespediatr.v94i5.4527
dc.identifier.urihttps://revistaschilenas.uchile.cl/handle/2250/238999
dc.descriptionObjectives: To characterize the COVID-19 disease profile in Chilean children hospitalized in pediatric intensive care units (PICU) and to evaluate risk factors associated with severe COVID-19.Patients and Method: A multicenter prospective cohort study with patients 0-18 years of age with confirmed SARS-CoV-2 hospitalized in PICU. Clinical, laboratory, imaging, and therapeutic variables were recorded. We compared ”mild/moderate COVID-19” with ”severe COVID-19” using median with interquartile range (IQR), Mann-Whitney U test, two-tailed Fisher’s test, and forward binary multivariate analysis to adjust variables for “severe COVID-19”. A p < 0.05 was considered significant.Results: From 16 PICUs, 219 patients were recruited, 55.3% were male, with a median age of 86 months (IQR: 13.5-156). The most frequent comorbidities were obesity and respiratory diseases. Overall mortality was 3.6%. “Severe COVID-19” (26.5%) showed more leukopenia, lymphopenia, increased inflammatory parameters, and altered organ function (p < 0.05). It also developed more sepsis/shock, ARDS, and organ dysfunction, requiring more hemodynamic, anti-inflammatory, anticoagulation, and antibiotic therapy, with a longer stay in the PICU/hospital (p < 0.05), and 13.8% of mortality. Risk factors associated with “severe COVID-19” were shock on admission to the PICU [aOR 28.44 (95%CI 10.45-77.4)], obesity [aOR 3.55 (95%CI 1.3-9.6)], consolidation [aOR 3.1 (95%CI 1.1 -8.7)], atelectasis [aOR: 8.7 (95%CI 1.17-64.3)], stress dose of corticosteroids [aOR 7.7 (95%CI 1.9-30.6)], early antibiotic therapy [aOR: 12.02 (95%CI 1.11-130.02)], acquired/congenital immunodeficiency [aOR: 19.2 (95%CI: 1.19-321)], and oncological pathology [aOR 10.7 (95%CI 2.14-47.8)].Conclusion: In this Chilean pediatric cohort, most patients with COVID-19 admitted to de PICU were male, of school age, with associated comorbidity. Risk factors for developing severe COVID-19 were the presence of comorbidities such as acquired/congenital immunodeficiency, oncological pathology, and obesity, in addition to shock on admission and consolidations on X-rays. en-US
dc.descriptionObjetivo: Caracterizar el comportamiento de COVID-19 en niños chilenos hospitalizados en unidades de paciente crítico pediátrico (UPCP) y evaluar factores de riesgo para COVID-19 severo.Pacientes y Método: Estudio multicéntrico cohorte prospectivo, pacientes 0-18 años con SARS-CoV-2 confirmado hospitalizados en UPCP. Se registraron variables clínicas, laboratorio, imagenológicas y terapéuticas. Se comparó “COVID-19 leve/moderado” versus “COVID-19 severo” utilizando mediana con rango intercuartil (RIC), test U Mann-Whitney, Test Fisher de dos colas y análisis multivariado binario forward para ajuste de variables para “COVID-19 severo”. Significativo p < 0,05.Resultados: 219 pacientes, 55,3% hombres, mediana edad 86 meses (RIC: 13,5-156). Comorbilidades principales: obesidad, enfermedades respiratorias. Mortalidad global: 3,6%. “COVID-19 severo” (26,5%) mostró más leucopenia, linfopenia, más inflamación y alteración de órganos (p < 0,05). También desarrolló más Sepsis/shock, SDRA y disfunción de órganos, requirió más terapia hemodinámica, antiinflamatoria, anticoagulación, antibioterapia, con mayor estadía en UPCP/hospitalaria (p < 0,05) y mortalidad de 13,8%. Factores de riesgo asociados a “COVID-19 severo”: shock al ingreso (aOR 28,44 [IC95%: 10,45-77,4]), obesidad (aOR 3,55 [IC95%: 1,3-9,6]), condensación (aOR 3,1 [IC95%: 1,1-8,7]), atelectasia (aOR: 8.7 [IC95%: 1,17-64,3]), corticoides dosis de estrés (aOR 7,7 [IC95%: 1,9-30,6]), antibioterapia precoz (aOR: 12,02 [IC95%: 1,11-130,02]), inmunodeficiencia adquirida/ congénita (aOR: 19,2 [IC95%: 1,19-321]) y patología oncológica (aOR: 10,7 [IC95%: 2,14-47,8]). Conclusión: En esta cohorte pediátrica chilena, el perfil de paciente que ingresó a UPCP fue de sexo masculino en edad escolar con comorbilidad asociada. Factores de riesgo asociados a COVID-19 severo fueron: presencia de comorbilidades (inmunodeficiencia adquirida/congénita, patología oncológica y obesidad), shock al ingreso y condensaciones en las imágenes radiológicas. es-ES
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dc.languagespa
dc.languageeng
dc.publisherSociedad Chilena de Pediatríaes-ES
dc.relationhttp://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4527/4609
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dc.rightsCopyright (c) 2023 Andes Pediatricaes-ES
dc.rightshttp://creativecommons.org/licenses/by/4.0es-ES
dc.sourceRevista Chilena de Pediatría; Vol. 94, Núm. 5 (2023): Septiembre - Octubre; 616-627en-US
dc.sourceAndes Pediatrica; Vol. 94, Núm. 5 (2023): Septiembre - Octubre; 616-627es-ES
dc.source2452-6053
dc.source2452-6053
dc.subjecten-US
dc.subjectChildren; SARS-CoV-2; COVID-19; Critical Care; Severe COVID-19en-US
dc.subjectes-ES
dc.subjectNiños; SARS-CoV-2; COVID-19; Cuidados Críticos; COVID-19 Severoes-ES
dc.titleExperience in COVID-19 in hospitalized patients in pediatric critical units during pandemic perioden-US
dc.titleExperiencia en COVID-19 en pacientes hospitalizados en unidades de paciente crítico pediátrico durante el periodo pandémicoes-ES
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.typeen-US
dc.typees-ES


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