RESUMO
The current coronavirus disease 2019 pandemic has been particularly challenging for the clinician because of the unclear nature of the underlying disease mechanisms. One of the hallmarks of the disease involves an increased risk of thrombosis and hypercoagulable state. Here, we describe 2 cases of patients admitted with submassive pulmonary embolism in the setting of positive tests for severe acute respiratory syndrome coronavirus 2.
Assuntos
COVID-19/diagnóstico por imagem , Pandemias , Embolia Pulmonar/diagnóstico por imagem , SARS-CoV-2/isolamento & purificação , Adolescente , COVID-19/complicações , COVID-19/patologia , COVID-19/virologia , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Embolia Pulmonar/etiologia , Embolia Pulmonar/patologia , Embolia Pulmonar/virologiaAssuntos
Betacoronavirus , Infecções por Coronavirus , Síndrome de Linfonodos Mucocutâneos , Pandemias , Pneumonia Viral , COVID-19 , Criança , Humanos , SARS-CoV-2RESUMO
OBJECTIVE: To assess the impact of nutritional status on outcomes like mortality rate, length of mechanical ventilation and length of Pediatric Intensive Care Unit (PICU) stay, in critically ill children. METHODS: In this retrospective study conducted at a tertiary care center, records of 332 critically ill children between 1 mo to 15 y of age for whom anthropometric parameters were available were included. Anthropometric parameters for the study subjects were used to assess the nutritional status using the WHO growth charts as the reference. The study subjects were categorized as non-malnourished, moderately, and severely malnourished, defined by Body mass index (BMI) for age 0 to -2 SD, -2 to -3 SD and less than -3 SD of WHO growth charts, respectively. Various outcomes like mortality, duration of PICU stay and duration of mechanical ventilation were assessed in the 3 groups based on the nutritional status. RESULTS: The prevalence of malnutrition in the index study was 51.2 % with an overall mortality of 38.8 %. No difference was found between mortality rates and proportion of ventilated children in the three study groups. However, more children who were severely malnourished had significantly prolonged ICU stay (>7 d) as well as duration of mechanical ventilation (>7 d). When the outcome variables were compared after adjusting for PIM2 scores, there were increasing odds of mortality, ventilation, prolonged PICU stay and duration of mechanical ventilation with increasing severity of malnutrition. CONCLUSIONS: After stabilization of the initial critical phase, PICU outcome is influenced by the nutritional status of the children.