Demographics, clinical and outcome features of children and adolescents with critical disease related to SARS-CoV-2
| Characteristics | Patients with critical disease related to SARS-CoV-2 | ||
| Demographics and epidemiological | Severe COVID-19 (n=141) | MIS-C (n=67) | All patients (n=208) |
| Age, in months, median (IQR) | 28 (9–101) | 53 (12–112) | 41.6 (9.6–103.1) |
| Male sex, n (%) | 65 (46.1) | 52 (77.6) | 117 (56.2) |
| Comorbidity*, n (%) | 75 (53.2) | 51 (76.2) | 126 (60.6) |
| Malnutrition, n (%) | 90 (63.8) | 39 (58.2) | 129 (62.0) |
| SARS-CoV-2 infection confirmed tests, n (%) | |||
| RT-PCR | 66/85 (77.6) | 21/61 (34.4) | 87/146 (59.6) |
| Antigen | 60/83 (72.3) | 28/52 (53.8) | 88/135 (65.2) |
| ELISA IgG | 4/47 (8.5) | 18/23 (78.3) | 22/70 (31.4) |
| ELISA IgM | 11/47 (23.4) | 4/23 (17.4) | 15/70 (21.4) |
| Clinical and intensive support | |||
| Cardiogenic shock, n (%) | 26 (18.4) | 28 (41.8) | 54 (30.0) |
| Mechanical ventilation support, n (%) | 52 (36.9) | 46 (68.7) | 98 (47.1) |
| Acute respiratory distress syndrome, n (%) | 38 (26.9) | 35 (52.2) | 71 (34.1) |
| Kidney disease: Improving Global Outcome classification system: stage 1/risk, n (%) | 70 (49.6) | 35 (52.2) | 105 (50.5) |
| Treatment | |||
| Low-molecular-weight heparin therapy, n (%) | 59 (41.8) | 49 (73.1) | 108 (51.9) |
| Methylprednisolone pulse therapy, n (%) | 4 (2.8) | 21 (31.3) | 25 (16.8) |
| Intravenous immunoglobulin therapy, n (%) | 25 (17.7) | 45 (67.2) | 70 (33.6) |
| Outcomes | |||
| Ventilator weaning success at first attempt, n (%) | 35 (24.8) | 42 (62.7) | 77 (37.0) |
| Tracheostomy tube use, n (%) | 8 (5.7) | 0 (0) | 8 (3.8) |
| Ventilator free days at 28th, median (IQR) | 1 (0–3) | 3 (1–9) | 3 (1–5) |
| Length of stay in PICU, in days, median (IQR) | 7 (2–12) | 5 (3–10) | 5 (2–10.5) |
| Length of stay in hospital, in days, median (IQR) | 14 (10–20) | 15 (10–19) | 14 (10–20) |
| Mechanical ventilation time, in days, median (IQR) | 6 (4–12) | 4 (1–7) | 4 (3–9) |
| Death, n (%) | 21 (14.9) | 16 (23.9) | 37 (17.8) |
*Comorbidities were present in 92/171 (53.8%) of survivors and in 34/37 (91.9%) of non survivors. 88/208 (42.3%) patients had more than 2 comorbidities, with 65/171 patients in the survivors group and 23/37 (62.2%) in the non-survivors group. In the severe COVID-19 and MIS-C group 67/141 (47.5%) and 21/67 (31.3%) patients had more than 2 comorbidities, respectively.
MIS-C, multisystem inflammatory syndrome in children; PICU, paediatric intensive care unit.