RESUMO
COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1-10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2-6.5), breathing difficulty OR: 3.4 (CI95%: 1.4-8.2), vomiting OR: 3.3 (CI95%: 1.4-7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9-16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.
Assuntos
COVID-19 , SARS-CoV-2 , Índice de Gravidade de Doença , Humanos , COVID-19/mortalidade , COVID-19/epidemiologia , COVID-19/diagnóstico , Criança , Masculino , Feminino , Pré-Escolar , Adolescente , Estudos Retrospectivos , Estudos Transversais , Lactente , SARS-CoV-2/isolamento & purificação , Bolívia/epidemiologia , Hospitalização , Unidades de Terapia Intensiva/estatística & dados numéricos , Fatores de Risco , Fatores SociodemográficosRESUMO
Con el objetivo de determinar la utilidad de un método de diagnóstico etiológico rápido en las faringitis se estudiarán a los niños que consultan en el Servicio de Emergencia Pediátrica del H.N.M.A.V durante el periodo de estudio. A todos se le realizarán exudados faringéos: para cultivo convencional y para detectar la presencia de antígenos de estreptococo beta hemolítico del grupo A. La utilización de éste método permite un tratamiento más racional en relación al uso de antibióticos en cuadros faríngeos.
