A multi-country analysis of COVID-19 hospitalizations by vaccination status.

BACKGROUND: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes. METHODS: Here, we use data from an international consortium to study this question and assess whether differences between these groups are context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed. FINDINGS: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed. CONCLUSIONS: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history. FUNDING: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill & Melinda Gates Foundation (OPP1209135); and the philanthropic support of the donors to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section.

Clinical-epidemiological and treatment characteristics of children with COVID-19 in a tertiary referral center in Peru / Características clínicas de niños con COVID-19 admitidos en un centro terciario de referencia en el Perú

Introduction: The COVID-19 pandemic has a great impact on children's health. This study describes the characteristics of hospitalized children at the San Borja National Children's Health Institute in Perú. Methods: This was a retrospective study of patients with a confirmed diagnosis of COVID-19 from March to July 2020. Demographic, clinical, laboratory, radiological, and treatment information were collected. Data analysis included descriptive statistics and bivariate analysis to determine differences between patients in general wards and the intensive care unit (ICU). Results: We included 91 patients, 33 being females (36.3%). The most affected age group was children > 2 years of age (63 cases) with a median age of 6 years (IQR 3-10), and 61.5% were from Lima. The previous contact was determined in 30.8% of cases. A positive SARS CoV-2 PCR result was obtained in 50.6%. The presence of comorbidity was 53.8%. The most frequent symptoms were: fever (39.6%), general malaise (23.1%), cough (19.8%), and respiratory distress (14.3%). The presence of multisystem inflammatory syndrome in children (MIS-C) was confirmed in 6 patients. Antibiotics were administered in 76.9%. The most frequent radiological pattern was bilateral interstitial infiltrates (57.7%). Mortality was higher in patients in the ICU than in the hospitalization ward (27.3% vs. 4.3%, respectively; p = 0.020) Conclusions: COVID-19 in children presents mild and moderate clinical manifestations. The presence of comorbidity is an important factor for hospitalization, and mortality is high upon admission to critical care units.

Introducción: La pandemia por COVID-19 representa un gran impacto en salud infantil, en este estudio se describe el comportamiento de esta enfermedad en pacientes pediátricos hospitalizados en el Instituto Nacional de Salud del Niño San Borja (INSN-SB) en el Perú. Métodos :Estudio retrospectivo de pacientes con diagnóstico confirmado de COVID-19 durante marzo a julio de 2020. Se recolectó información demográfica, clínica, laboratorial, radiológica y de tratamiento, para el análisis de datos se incluyó estadística descriptiva y un análisis bivariado para determinar las diferencias de pacientes en salas de hospitalización y la Unidad de cuidados intensivos pediátrico (UCIP). Resultados: Se incluyeron 91 pacientes, 33 de sexo femenino (36,3%). El grupo etario más afectado fueron los niños > de 2 años de edad (63 casos) con una mediana de edad de 6 años (RIC 1-8). 61,5% de pacientes procedían de Lima. El resultado de PCR SARS CoV-2 fue positivo en el 50,6%. La presencia de comorbilidad fue 53,8%. Los síntomas más frecuentes fueron fiebre (39,6%), malestar general (23,1%), tos (19.8%) y dificultad respiratoria (14,3%). La presencia de síndrome inflamatorio multisistémico (MIS-C) se confirmó en 6 pacientes. El uso de antibióticos representó 76,9%. El patrón radiológico más frecuente fue intersticial bilateral (57,7%). La mortalidad fue mayor en pacientes de UCI frente a los de salas de hospitalización (27,3% vs. 4,3%, respectivamente; p = 0.020). Conclusiones: El COVID-19 en niños presenta manifestaciones clínicas leves y moderadas. La presencia de comorbilidades es un factor importante de hospitalización, y la mortalidad es alta en pacientes admitidos a UCIP.