Predictors of Death in Severe New Coronavirus Infection in Children

Author:

Аleksandrovich Yu. S.1,Prometnoy D. V.2,Mironov P. I.3,Pshenisnov K. V.1,Anchutin P. E.4,Teplyakova E. D.5

Affiliation:

1. St. Petersburg State Pediatric Medical University

2. Russian Children Clinical Hospital, Pirogov Russian National Research Medical University

3. Bashkir State Medical University

4. Federal Research Clinical Center of Reanimatology and Rehabilitation, the Russian Ministry of Science and Higher Education

5. Rostov State Medical University

Abstract

Currently, in pandemic settings, the new coronavirus infection is the leading cause of adult fatalities and may cause death of children with comorbidities.The objective of the study is to identify predictors of the fatality of the new coronavirus infection in children.Subjects and Methods. 230 patients with the new coronavirus infections were examined. The main group of 94 patients with severe COVID-19, the fatal outcome occurred in 25 (26.6%) children. The comparison group consisted of 126 children with a moderate degree of severity, and there were no lethal outcomes.Results. Children older than 10 years of age (43%) prevailed in the study cohort. Every fifth patient in the main group suffered from shock, and 79 (84%) children had failure of two or more systems/organs. The presence of pronounced manifestations of the disease was associated with a 20-fold increase in the probability of a severe course of COVID-19 (OR = 0.04). Involvement of two organs and systems doubled the risk of death. An acceptable discriminatory ability of the pSOFA score for predicting COVID-19 outcomes in children was identified: sensitivity 83%, specificity 61%, cut-off point 5.6 points.Conclusion. Predictors of death in severe new coronavirus infection in children include failure of two or more organs and systems, acute renal injury and the pSOFA score above 5.

Publisher

New Terra

Subject

Anesthesiology and Pain Medicine,Critical Care and Intensive Care Medicine,Emergency Medicine

Reference15 articles.

1. Аleksandrovich Yu. S., Аlekseeva E. I., Bakradze M. D. et al. Guidelines on specific clinical signs and treatment of disorders caused by the new coronavirus infection (COVID-19) in children. Pediatricheskaya Pharmocologiya, 2020, vol. 17, no. 3, pp. 187-212. (In Russ.) https://doi.org/10.15690/pf.v17i3.2123.

2. Mamaev А. N, Kudlay D. A. Statisticheskiye metody v meditsine. [Statistical methods in medicine]. Moscow, Prakticheskaya Meditsina Publ., 2021. 136 p.

3. Pshenisnov K. V., Аleksandrovich Yu. S., Kaziakhmedov V. A. et al. A new coronavirus infection in children with comorbidities: there is always a chance for recovery. Journal Infektologii, 2020, vol. 12, no. 3, pp. 80-89. (In Russ.) https://doi.org/10.22625/2072-6732-2020-12-3-80-89.

4. Bousquet J., Zuberbier T., Anto J. M., Iaccarino G., Czarlewski W., Anto A., Haahtela T., Akdis C. A., Blain H., Canonica G. W., Cardona V., Cruz A. A., Illario M., Ivancevich J. C., Jutel M., Klimek L., Kuna P., Laune D., Larenas-Linnemann D., Mullol J. et al. Is diet partly responsible for differences in covid-19 death rates between and within countries? Clin. Translat. Allergy, 2020, vol. 10, no. 1, pp. 16. https://doi.org/doi.org/10.1186/s13601-020-00323-0.

5. Chao J. Y., Derespina K. R., Herold B. C. et al. Clinical characteristics and outcomes of hospitalized and critically ill children and adolescents with coronavirus disease 2019 at a tertiary care medical center in New York City. J. Pediatr., 2020, vol. 223, pp. 14-19.e2. https://doi.org/10.1016/j.jpeds.2020.05.006.

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