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Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care.
Rowan, Courtney M; LaBere, Brenna; Young, Cameron C; Zambrano, Laura D; Newhams, Margaret M; Kucukak, Suden; McNamara, Elizabeth R; Mack, Elizabeth H; Fitzgerald, Julie C; Irby, Katherine; Maddux, Aline B; Schuster, Jennifer E; Kong, Michele; Dapul, Heda; Schwartz, Stephanie P; Bembea, Melania M; Loftis, Laura L; Kolmar, Amanda R; Babbitt, Christopher J; Nofziger, Ryan A; Hall, Mark W; Gertz, Shira J; Cvijanovich, Natalie Z; Zinter, Matt S; Halasa, Natasha B; Bradford, Tamara T; McLaughlin, Gwenn E; Singh, Aalok R; Hobbs, Charlotte V; Wellnitz, Kari; Staat, Mary A; Coates, Bria M; Crandall, Hillary R; Maamari, Mia; Havlin, Kevin M; Schwarz, Adam J; Carroll, Christopher L; Levy, Emily R; Moffitt, Kristin L; Campbell, Angela P; Randolph, Adrienne G; Chou, Janet.
Afiliação
  • Rowan CM; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA.
  • LaBere B; Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Young CC; Division of Pulmonology, Section of Allergy-Immunology, Phoenix Children's Hospital, Phoenix, Arizona, USA.
  • Zambrano LD; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Newhams MM; Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Kucukak S; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
  • McNamara ER; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Mack EH; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Fitzgerald JC; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Irby K; Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Maddux AB; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
  • Schuster JE; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
  • Kong M; Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.
  • Dapul H; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Schwartz SP; Division of Pediatric Critical Care Medicine, Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, New York, USA.
  • Bembea MM; Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina, USA.
  • Loftis LL; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Kolmar AR; Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
  • Babbitt CJ; Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, USA.
  • Nofziger RA; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Miller Children's and Women's Hospital of Long Beach, Long Beach, California, USA.
  • Hall MW; Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio, USA.
  • Gertz SJ; Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
  • Cvijanovich NZ; Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA.
  • Zinter MS; Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, Oakland, California, USA.
  • Halasa NB; Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, California, USA.
  • Bradford TT; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • McLaughlin GE; Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana, USA.
  • Singh AR; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Hobbs CV; Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
  • Wellnitz K; Department of Pediatrics, Division of Infectious Diseases, Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
  • Staat MA; Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
  • Coates BM; Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Crandall HR; Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
  • Maamari M; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA.
  • Havlin KM; Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas, Texas, USA.
  • Schwarz AJ; Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Louisville, and Norton Children's Hospital, Louisville, Kentucky, USA.
  • Carroll CL; Division of Critical Care Medicine, Children's Health Orange County (CHOC), Orange, California, USA.
  • Levy ER; Division of Critical Care, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
  • Moffitt KL; Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Campbell AP; Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Randolph AG; Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Chou J; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Clin Infect Dis ; 79(2): 395-404, 2024 Aug 16.
Article em En | MEDLINE | ID: mdl-38465976
ABSTRACT

BACKGROUND:

We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care.

METHODS:

Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted 12 March 2020-30 December 2021 to the pediatric intensive care unit (PICU) or high-acuity unit for acute COVID-19 were included.

RESULTS:

Of 1274 patients, 105 (8.2%) had an ICC, including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid-organ transplantation, 16 (15.2%) solid tumors, and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs 4.6%, P = .005) and hospitalization was longer (P = .01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, P = .40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19.

CONCLUSIONS:

In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Unidades de Terapia Intensiva Pediátrica / Hospedeiro Imunocomprometido / SARS-CoV-2 / COVID-19 Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Unidades de Terapia Intensiva Pediátrica / Hospedeiro Imunocomprometido / SARS-CoV-2 / COVID-19 Idioma: En Ano de publicação: 2024 Tipo de documento: Article