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Tytuł:
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Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study.
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Autorzy:
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Prata-Barbosa A; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil. Electronic address: .
Lima-Setta F; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.
Santos GRD; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.
Lanziotti VS; Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
de Castro REV; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
de Souza DC; Hospital Sírio Libanês, São Paulo, SP, Brazil.
Raymundo CE; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.
de Oliveira FRC; Hospital Alvorada Moema, São Paulo, SP, Brazil.
de Lima LFP; Hospital SEPACO, São Paulo, SP, Brazil.
Tonial CT; Pontifícia Universidade Católica (PUC-RS), Porto Alegre, RS, Brazil.
Colleti J Jr; Hospital Assunção, São Bernardo do Campo, SP, Brazil.
Bellinat APN; Hospital Martagão Gesteira, Salvador, BA, Brazil.
Lorenzo VB; Hospital Couto Maia, Salvador, BA, Brazil.
Zeitel RS; Universidade do Estado do Rio de Janeiro (UERJ), Hospital Pedro Ernesto, Rio de Janeiro, RJ, Brazil.
Pulcheri L; Hospital Rios D'Or, Rio de Janeiro, RJ, Brazil.
Costa FCMD; Hospital Quinta D'Or, Rio de Janeiro, RJ, Brazil.
La Torre FPF; Hospital Sino Brasileiro, Osasco, SP, Brazil.
Figueiredo EADN; Hospital Pediátrico Unimed, Belém, PA, Brazil.
Silva TPD; Hospital Real D'Or, Rio de Janeiro, RJ, Brazil.
Riveiro PM; Hospital Caxias D'Or, Duque de Caxias, RJ, Brazil.
Mota ICFD; Hospital Jutta Batista, Rio de Janeiro, RJ, Brazil.
Brandão IB; Hospital Niteroi D'Or, Rio de Janeiro, RJ, Brazil.
de Azevedo ZMA; Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, RJ, Brazil.
Gregory SC; Hospital Estadual da Criança, Rio de Janeiro, RJ, Brazil.
Boedo FRO; Hospital Norte D'Or, Rio de Janeiro, RJ, Brazil.
de Carvalho RN; Hospital Santa Izabel, Santa Casa da Misericórdia, Salvador, BA, Brazil.
Castro NAASR; Hospital da Criança, Faculdade de Medicina, São José do Rio Preto, SP, Brazil.
Genu DHS; Hospital Estadual Getúlio Vargas, Rio de Janeiro, RJ, Brazil.
Foronda FAK; Hospital Sírio Libanês, São Paulo, SP, Brazil.
Cunha AJLA; Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
de Magalhães-Barbosa MC; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.
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Corporate Authors:
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Brazilian Research Network in Pediatric Intensive Care, (BRnet-PIC); Brazilian Research Network in Pediatric Intensive Care (BRnet-PIC), Brazil.
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Źródło:
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Jornal de pediatria [J Pediatr (Rio J)] 2020 Sep - Oct; Vol. 96 (5), pp. 582-592. Date of Electronic Publication: 2020 Aug 04.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Rio de Janeiro, Brazil : Elsevier Editora Ltda
Original Publication: Rio de Janeiro.
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MeSH Terms:
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Pandemics*
Systemic Inflammatory Response Syndrome*
Coronavirus Infections/*therapy
Intensive Care Units, Pediatric/*statistics & numerical data
Pneumonia, Viral/*therapy
Respiration, Artificial/*methods
Adolescent ; Betacoronavirus ; Brazil ; COVID-19 ; Child ; Child, Preschool ; Coronavirus Infections/epidemiology ; Female ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Length of Stay/statistics & numerical data ; Male ; Pneumonia, Viral/epidemiology ; Prospective Studies ; Respiration, Artificial/statistics & numerical data ; SARS-CoV-2
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References:
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J Intensive Care. 2020 May 24;8:36. (PMID: 32483488)
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Contributed Indexing:
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Keywords: Brasil; Brazil; COVID-19; Pediatria; Pediatric intensive care; Pediatrics; SARS-CoV-2; Terapia intensiva pediátrica
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SCR Disease Name:
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pediatric multisystem inflammatory disease, COVID-19 related
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Entry Date(s):
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Date Created: 20200812 Date Completed: 20201022 Latest Revision: 20220910
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Update Code:
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20240105
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PubMed Central ID:
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PMC7402103
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DOI:
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10.1016/j.jped.2020.07.002
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PMID:
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32781034
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Objective: To describe the clinical characteristics of children and adolescents admitted to intensive care with confirmed COVID-19.
Method: Prospective, multicenter, observational study, in 19 pediatric intensive care units. Patients aged 1 month to 19 years admitted consecutively (March-May 2020) were included. Demographic, clinical-epidemiological features, treatment, and outcomes were collected. Subgroups were compared according to comorbidities, age < 1 year, and need for invasive mechanical ventilation. A multivariable logistic regression model was used for predictors of severity.
Results: Seventy-nine patients were included (ten with multisystemic inflammatory syndrome). Median age 4 years; 54% male (multisystemic inflammatory syndrome, 80%); 41% had comorbidities (multisystemic inflammatory syndrome, 20%). Fever (76%), cough (51%), and tachypnea (50%) were common in both groups. Severe symptoms, gastrointestinal symptoms, and higher inflammatory markers were more frequent in multisystemic inflammatory syndrome. Interstitial lung infiltrates were common in both groups, but pleural effusion was more prevalent in the multisystemic inflammatory syndrome group (43% vs. 14%). Invasive mechanical ventilation was used in 18% (median 7.5 days); antibiotics, oseltamivir, and corticosteroids were used in 76%, 43%, and 23%, respectively, but not hydroxychloroquine. The median pediatric intensive care unit length-of-stay was five days; there were two deaths (3%) in the non- multisystemic inflammatory syndrome group. Patients with comorbidities were older and comorbidities were independently associated with the need for invasive mechanical ventilation (OR 5.5; 95% CI, 1.43-21.12; p = 0.01).
Conclusions: In Brazilian pediatric intensive care units, COVID-19 had low mortality, age less than 1 year was not associated with a worse prognosis, and patients with multisystemic inflammatory syndrome had more severe symptoms, higher inflammatory biomarkers, and a greater predominance of males, but only comorbidities and chronic diseases were independent predictors of severity.
(Copyright © 2020 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)
