A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral

Abstract

Introduction: To date, little is known about the clinical features of pediatric COVID-19 patients admitted to intensive care units (ICUs). Objective: Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes of Iranian pediatric COVID-19 patients admitted to ICU versus those in non-ICU settings. Methods: This multicenter investigation involved 15 general and pediatrics hospitals and included cases with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive real-time reverse transcription polymerase chain reaction (RT-PCR) admitted to these centers between March and May 2020, during the initial peak of the COVID-19 pandemic in Iran. Results: Overall, 166 patients were included, 61 (36.7%) of whom required ICU admission. The highest number of admitted cases to ICU were in the age group of 1–5 years old. Malignancy and heart diseases were the most frequent underlying conditions. Dyspnea was the major symptom for ICU-admitted patients. There were significant decreases in PH, HCO3 and base excess, as well as increases in creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and potassium levels between ICU-admitted and non-ICU patients. Acute respiratory distress syndrome (ARDS), shock, and acute cardiac injury were the most common features among ICU-admitted patients. The mortality rate in the ICU-admitted patients was substantially higher than non-ICU cases (45.9% vs. 1.9%, respectively; p<0.001). Conclusions: Underlying diseases were the major risk factors for the increased ICU admissions and mortality rates in pediatric COVID-19 patients. There were few paraclinical parameters that could differentiate between pediatrics in terms of prognosis and serious outcomes of COVID-19. Healthcare providers should consider children as a high-risk group, especially those with underlying medical conditions.

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IssueVol 5 No 4 (2021): Autumn (October) QRcode
SectionOriginal article
DOI 10.18502/fem.v5i4.6692
Keywords
COVID-19 Intensive Care Units Pediatric Respiratory Tract Infections SARS-CoV-2
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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1.
Fahimzad A, Sedighi I, Pak N, Khalili M, Farahmand M, Shokrollahi MR, Heydari H, Movahedi Z, Sanaei Dashti A, Cheraghali F, Shamsizadeh A, Mirkarimi M, Alisamir M, Hashemian H, Soltani J, Hosseininasab A, Hamedi A, Rezai MS, Sayyahfar S, Kahbazi M, Abedini A, Akhondzadeh A, Sherkatolabbasieh HR, Razlansari AA, Alibeik M, Malayeri SO, Shalchi Z, Shahabinezhad A, Khalkhali Asl P, Erfani Y, Norouzi M, Nafe Monfared F, Maleki S, Kakavand R, Shahbaz B, Poortahmasebi V, Akhavan Rezayat S, Karimi MR, Jafarpour A, Soltani S, Ghaziasadi A, Dowran R, Azimi S, Sadeghipour Marvi S, Abazari F, Zandi M, Jazayeri SM, Tavakoli A. A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral. Front Emerg Med. 2021;5(4):e41.

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