■儿科COVID-19流行病学和与不良结局相关的因素-死亡率,需要有创机械通气,ICU入院,基本上没有研究。我们描述了菲律宾儿童COVID-19患者的临床人口统计学特征,并确定了与不良结局相关的因素。
这是一项回顾性队列研究,研究了2020年4月至2021年8月在马尼拉的COVID-19三级转诊医院进行的180例0-18岁的SARS-CoV-2住院确诊病例,国家首都地区。使用卡方或Fisher精确检验确定粗关联;使用Mann-Whitney检验比较中位数。使用Cox比例风险回归分析确定预测死亡率的因素。幸存者功能在图中描绘。
■约41.67%患有轻度疾病,58.33%为男性,39.4%,0-4岁,69.44%有至少一种合并症。约9.44%死亡(调整后,每1000名患者天有9.2人死亡,95%CI5.5%-15.2%),17.78%需要有创机械通气,20%需要入住ICU。独立地,重症COVID-19(HRc11.51,95%CI3.23,41.06),撤回(HRc10.30,95%CI3.27,32.47),鼻翼耀斑(HRc4.39,95%CI1.53,12.58),紫癜(HRc4.39,95%CI1.72,14.11),呼吸困难(HRc7.99,95%CI2.25,28.71),吸/食欲差(HRc4.46,95%CI1.59,12.40),铁蛋白(HRc1.01,95%CI1.00,1.01),IL-6(HRc1.01,95%CI1.00,1.01),aPTT(HRc1.05,95%CI1.01,1.10),IVIg(HRc4.00,95%CI1.07,14.92)和皮质类固醇(HRc6.01,95%CI2.04,17.67)是死亡率的显著危险因素。在调整后的Cox分析中,仅撤回(HRa34.96,95%CI3.36,363.79),癫痫发作(HRa9.98,95%CI1.76,56.55),和皮质类固醇(HRa8.21,95%CI1.12,60.38)与死亡率显着相关,而鼻翼耀斑似乎具有保护性(HRa0.10,95%CI0.01,0.95)。一些临床特征与不良结局一致相关。
■大多数住院儿科COVID-19患者非常年轻,男性,患有轻度疾病,至少有一种合并症.死亡率,有创机械通气,ICU入院率相对较低。除了似乎是保护性的鼻翼耀斑,撤回,癫痫发作,糖皮质激素的使用与不良结局相关.
UNASSIGNED: Pediatric COVID-19 epidemiology and factors associated with adverse outcomes - mortality, need for invasive mechanical ventilation, and ICU admission, are largely unstudied. We described the clinico-demographic characteristics of Filipino pediatric COVID-19 patients and determined the factors associated with adverse outcomes.
UNASSIGNED: This is a retrospective cohort study of 180 hospitalized SARS-CoV-2-confirmed cases 0-18 years old from April 2020 to August 2021 in a tertiary COVID-19 referral hospital in Manila, National Capital Region. Crude associations were determined using chi-squared or Fisher\'s exact tests; and medians were compared using the Mann-Whitney test. Factors predictive of mortality were determined using Cox proportional
hazards regression analysis. The survivor functions were depicted in graphs.
UNASSIGNED: About 41.67% had mild disease, 58.33% were males, 39.4% aged 0-4 years, and 69.44% had at least one comorbidity. About 9.44% died (adjusted 9.2 persons per 1000 patient-days, 95% CI 5.5%-15.2%), 17.78% needed invasive mechanical ventilation, and 20% needed ICU admission. Independently, severe-critical COVID-19 (HRc 11.51, 95% CI 3.23, 41.06), retractions (HRc 10.30, 95% CI 3.27, 32.47), alar flaring (HRc 4.39, 95% CI 1.53, 12.58), cyanosis (HRc 4.39, 95% CI 1.72, 14.11), difficulty of breathing (HRc 7.99, 95% CI 2.25, 28.71), poor suck/appetite (HRc 4.46, 95% CI 1.59, 12.40), ferritin (HRc 1.01, 95% CI 1.00, 1.01), IL-6 (HRc 1.01, 95% CI 1.00, 1.01), aPTT (HRc 1.05, 95% CI 1.01, 1.10), IVIg (HRc 4.00, 95% CI 1.07, 14.92) and corticosteroid (HRc 6.01, 95% CI 2.04, 17.67) were significant
hazards for mortality. In adjusted Cox analysis, only retractions (HRa 34.96, 95% CI 3.36, 363.79), seizure (HRa 9.98, 95% CI 1.76, 56.55), and corticosteroids (HRa 8.21, 95% CI 1.12, 60.38) were significantly associated with mortality while alar flaring appeared to be protective (HRa 0.10, 95% CI 0.01, 0.95). Several clinical characteristics were consistently associated with adverse outcomes.
UNASSIGNED: Majority of hospitalized pediatric COVID-19 patients were very young, males, had mild disease, and had at least one comorbidity. Mortality, invasive mechanical ventilation, and ICU admission were relatively low. Except for alar flaring which appeared to be protective, retractions, seizure, and use of corticosteroids were associated with adverse outcomes.