Your browser doesn't support javascript.
loading
Severity and mortality associated with COVID-19 among children hospitalised in tertiary care centres in India: a cohort study.
Gupta, Vidushi; Singh, Amitabh; Ganju, Sheetal; Singh, Raghvendra; Thiruvengadam, Ramachandran; Natchu, Uma Chandra Mouli; Gupta, Nitesh; Kaushik, Deepali; Chanana, Surbhi; Sharma, Dharmendra; Gosain, Mudita; Rao, Suman Pn; Pandey, Narendra; Gupta, Arvind; Singh, Sandeep; Jhamb, Urmila; Annayappa Venkatesh, Lalitha; Dinakar, Chitra; Pandey, Anil Kumar; Gera, Rani; Chellani, Harish; Wadhwa, Nitya; Bhatnagar, Shinjini.
Afiliação
  • Gupta V; Translational Health Science and Technology Institute (THSTI), Faridabad, India.
  • Singh A; Vardhman Mahavir Medical College and Safdarjung Hospital (VMMC & SJH), New Delhi, India.
  • Ganju S; Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, India.
  • Singh R; All India Institute of Medical Sciences (AIIMS)-Jammu, Vijaypur, Jammu, India.
  • Thiruvengadam R; Maulana Azad Medical College, and Lok Nayak Hospital (MAMC & LNH), New Delhi, India.
  • Natchu UCM; Translational Health Science and Technology Institute (THSTI), Faridabad, India.
  • Gupta N; Pondicherry Institute of Medical Sciences (PIMS), Puducherry, India.
  • Kaushik D; St. John's Medical College and Research Institute (SJRI), Bengaluru, India.
  • Chanana S; Vardhman Mahavir Medical College and Safdarjung Hospital (VMMC & SJH), New Delhi, India.
  • Sharma D; Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, India.
  • Gosain M; Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, India.
  • Rao SP; Translational Health Science and Technology Institute (THSTI), Faridabad, India.
  • Pandey N; Translational Health Science and Technology Institute (THSTI), Faridabad, India.
  • Gupta A; St. John's Medical College and Research Institute (SJRI), Bengaluru, India.
  • Singh S; Asian Institute of Medical Sciences (ASIAN), Faridabad, India.
  • Jhamb U; Asian Institute of Medical Sciences (ASIAN), Faridabad, India.
  • Annayappa Venkatesh L; Asian Institute of Medical Sciences (ASIAN), Faridabad, India.
  • Dinakar C; Maulana Azad Medical College, and Lok Nayak Hospital (MAMC & LNH), New Delhi, India.
  • Pandey AK; St. John's Medical College and Research Institute (SJRI), Bengaluru, India.
  • Gera R; St. John's Medical College and Research Institute (SJRI), Bengaluru, India.
  • Chellani H; Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, India.
  • Wadhwa N; Vardhman Mahavir Medical College and Safdarjung Hospital (VMMC & SJH), New Delhi, India.
  • Bhatnagar S; Vardhman Mahavir Medical College and Safdarjung Hospital (VMMC & SJH), New Delhi, India.
Lancet Reg Health Southeast Asia ; 13: 100203, 2023 Jun.
Article em En | MEDLINE | ID: mdl-37159588
ABSTRACT

Background:

It is critical to identify high-risk groups among children with COVID-19 from low-income and middle-income countries (LMICs) to facilitate the optimum use of health system resources. The study aims to describe the severity and mortality of different clinical phenotypes of COVID-19 in a large cohort of children admitted to tertiary care hospitals in India.

Methods:

Children aged 0-19 years with evidence of SARS-CoV-2 infection (real time polymerase chain reaction or rapid antigen test positive) or exposure (anti-SARS-CoV-2 antibody, or history of contact with SARS-CoV-2) were enrolled in the study, between January 2021 and March 2022 across five tertiary hospitals in India. All study participants enrolled prospectively and retrospectively were followed up for three months after discharge. COVID-19 was classified into severe (Multisystem Inflammatory Syndrome in Children (MIS-C), severe acute COVID-19, 'unclassified') or non-severe disease. The mortality rates were estimated in different phenotypes.

Findings:

Among 2468 eligible children enrolled, 2148 were hospitalised. Signs of illness were present in 1688 (79%) children with 1090 (65%) having severe disease. High mortality was reported in MIS-C (18.6%), severe acute COVID-19 (13.3%) and the unclassified severe COVID-19 disease (12.3%). Mortality remained high (17.5%) when modified MIS-C criteria was used. Non-severe COVID-19 disease had 14.1% mortality when associated with comorbidity.

Interpretation:

Our findings have important public health implications for low resource settings. The high mortality underscores the need for better preparedness for timely diagnosis and management of COVID-19. Children with associated comorbidity or coinfections are a vulnerable group and need special attention. MIS-C requires context specific diagnostic criteria for low resource settings. It is important to evaluate the clinical, epidemiological and health system-related risk factors associated with severe COVID-19 and mortality in children from LMICs.

Funding:

Department of Biotechnology, Govt of India and Department of Maternal, Child and Adolescent Health and Aging, WHO, Geneva, Switzerland.
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article