Casassola GM, Schmidt CJ, Affeldt G, Morais DS, Alvarenga LKB, Miller C, Ziegler B Functional status of hospitalized pediatric patients with COVID-19 in southern Brazil: a prospective cohort study

Abstract

Objective: The present study aimed to assess the functional status of children diagnosed with COVID-19 at the time of hospitalization and the associations with clinical features. Methods: This prospective cohort study was carried out with children diagnosed with COVID-19 admitted to a tertiary hospital. The patients' functioning was assessed using the pediatric Functional Status Scale (FSS). Results: A total of 62 children with a median age of 3 years old were included in the study, and 70% had some comorbidity prior to the diagnosis of COVID-19. The median length of stay was nine days, during which period five patients died. The FSS assessment of the sample showed that approximately 55% had some functional alteration. The group of patients with the highest FSS scores presented a lengthier hospital stay (p = 0.016), required more oxygen therapy (p < 0.001), mechanical ventilation (p = 0.001), and intensive care unit admissions (p = 0.019), and had more cardiac (p = 0.007), neurological (p = 0.003), and respiratory (p = 0.013) comorbidities. In the multivariate analysis, there was an association between the dependent variable length of stay and the total FSS score (b = 0.349, p = 0.004) and the presence of comorbidities (b = 0.357, p = 0.004). Conclusions: We observed that more than half of the children hospitalized due to COVID-19 had some level of functional change. Greater alterations in functional status were associated with the presence of previous comorbidities, a greater need for ventilatory support, and longer hospital stays.

One-year follow-up of children hospitalized with COVID-19: a prospective cohort study

“…Casassola et al demonstrated that over half of children hospitalized with COVID-19 have impaired functionality, which they found to be associated with a longer hospital stay and a greater likelihood of requiring ventilatory support. 26 Their findings suggest that pediatric patients with reduced functionality tend to develop the more severe forms of COVID-19 and that one-year mortality rates would therefore be higher among such patients, thus corroborating our findings.…”

“…Similar data can be found in the literature. 17 , 26 Most of the children hospitalized with COVID-19 have preexisting comorbidities. 7 , 10 , 11 The presence of comorbidities is considered a risk factor for the development of more severe COVID-19 and for unfavorable outcomes such as death.…”

“…Casassola et al demonstraram que mais da metade das crianças hospitalizadas com COVID-19 apresentam funcionalidade prejudicada, relacionada a um maior tempo de internação hospitalar e uma maior probabilidade de necessitar de suporte ventilatório. (26) Esses achados sugerem que pacientes pediátricos com funcionalidade reduzida tendem a apresentar formas mais graves de COVID-19 e que as taxas de mortalidade em um ano seriam, portanto, mais altas nesses pacientes, corroborando assim nossos achados.…”

“…Dados semelhantes podem ser encontrados na literatura. (17,26) A maioria das crianças hospitalizadas com COVID-19 tem comorbidades preexistentes. (7,10,11) A presença de comorbidades é considerada um fator de risco de COVID-19 mais grave e desfechos desfavoráveis, como o óbito.…”