A multicenter national survey of children with SARS-CoV-2 infection admitted to Spanish Pediatric Intensive Care Units

Cortés, Rafael González; García-Salido, Alberto; Barrio, María Slöcker; Arriortúa, A. Bustinza; Cid, J. López-Herce; Vicente, Juan Carlos de; Tejedor, Maite Cuervas-Mons; Ugidos, Pedro Pablo Oyágüez; Jordán, Iolanda; Guitart, Carmina; Cárdenas, Sonia Sanchíz; Gil-Antón, Javier; Joyanes, Belén; Olmos, Ainhoa Jiménez; Núñez, Antonio Rodríguez; Quintela, Javier Trastoy; Yuste, Alexandra Hernández; Munilla, Laura Díaz; Reyes, Carlos Solís; Ramos, L Medina; Pascual, David Roca; Ramírez, Joan Ballcels; Fernández, Mario Sánchez; Gordillo, Inés Leóz; Galán, Corsino Rey; Cambra, Alfredo Molina; Garzón, Manuel González-Ripoll; Padial, Pepe Fernández-Cantalejo; Oulego-Erróz, Ignacio; Puyal, Laia Vega; Moreno, Daniel; Romero, Emilia Fernández; Besteiro, María García; González, J.; Monzón, Carmen Medina; Labarga, Beatriz Huidobro; Palomo, Rosa María Hernández; Monge, Cristina Calvo; Fernández, Francisco Arnalich; González, N. C.; Francisco, César Villa; Barrezueta, Lorena Bermúdez; Molina, Ana Abril; Valerón, Mónica; Rastrollo, Ramón Hernández; Hofheinz, Sylvia Belda; Mediavilla, Manuel Gijón; Martínez, José Luis; Frias, M.; Yéboles, Raúl Montero; Bonet, J.I. Muñoz; Velázquez, Maria Jose Martinez; Ganfornina, Inma Sánchez; Iranzo, Antonio Pérez; Lozano, David Mañero; Sorribes, Clara; Peña, María Soledad Holanda; Jimeno, Míriam Gutiérrez

doi:10.1007/s00134-020-06146-8

Cited by 16 publications

(14 citation statements)

References 4 publications

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“…Although infrequent, most of the cases of PMIS require hospitalization and intense clinical management because of the severity of the disease. Two recent multicenter studies in Spain reported that up to 31/252 (12%) of hospitalized children with COVID-19 and that 27/50 (54%) of cases that required PICU admission were diagnosed as PMIS[ 43 , 86 ].…”

Section: Resultsmentioning

confidence: 99%

“…Given the smaller numbers of pediatric cases of COVID-19 regarding adults, there is still scarce data about the role of cardiovascular involvement in COVID-19 in children. Of note, up to 34% of children with COVID admitted to the PICU in Spain presented with signs of heart dysfunction[ 43 ]. Besides, there is a suggestion that, as with other viral illnesses such as respiratory syncytial virus or influenza, children with underlying cardiac conditions are also at greater risk of cardiac complications or develop a more severe SARS-CoV-2 infection[ 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Rodríguez-González

Castellano-Martínez

Cascales-Poyatos³

et al. 2020

WJCC

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BACKGROUND Since the beginning of the pandemic, coronavirus disease-2019 (COVID-19) in children has shown milder cases and a better prognosis than adults. Although the respiratory tract is the primary target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cardiovascular involvement is emerging as one of the most significant and life-threatening complications of SARS-CoV-2 infection in adults. AIM To summarize the current knowledge about the potential cardiovascular involvement in pediatric COVID-19 in order to give a perspective on how to take care of them during the current pandemic emergency. METHODS Multiple searches in MEDLINE, PubMed were performed using the search terms “COVID-19” or “SARS-CoV-2" were used in combination with “myocardial injury” or "arrhythmia" or “cardiovascular involvement” or "heart disease" or "congenital heart disease" or “pulmonary hypertension” or "long QT" or “cardiomyopathies” or “channelopathies” or "Multisystem inflammatory system" or "PMIS" or “MIS-C” or ”Pediatric multisystem inflammatory syndrome" or "myocarditis" or "thromboembolism to identify articles published in English language from January 1st, 2020 until July 31st, 2020. The websites of World Health Organization, Centers for Disease control and Prevention, and the Johns Hopkins Coronavirus Resource Center were reviewed to provide up to date numbers and infection control recommendations. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts concerning the subject were reviewed by the authors, and the data were extracted using a standardized collection tool. Data were subsequently analyzed with descriptive statistics. For Pediatric multisystemic inflammatory syndrome temporally associated with COVID-19 (PMIS), multiple meta-analyses were conducted to summarize the pooled mean proportion of different cardiovascular variables in this population in pseudo-cohorts of observed patients. RESULTS A total of 193 articles were included. Most publications used in this review were single case reports, small case series, and observational small-sized studies or literature reviews. The meta-analysis of 16 studies with size > 10 patients and with complete data about cardiovascular involvement in children with PMIS showed that PMIS affects mostly previously healthy school-aged children and adolescents presenting with Kawasaki disease-like features and multiple organ failure with a focus on the heart, accounting for most cases of pediatric COVID-19 mortality. They frequently presented cardiogenic shock (53%), ECG alterations (27%), myocardial dysfunction (52%), and coronary artery dilation (15%). Most cases required PICU admission (75%) and inotropic support (57%), with the rare need for extracorporeal membrane oxygenation (4%). Almost all of these children wholly recovered in a few days, although rare deaths have been reported (2%). Out of PMIS cases we ide...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Rodríguez-González

Castellano-Martínez

Cascales-Poyatos³

et al. 2020

WJCC

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“…A report from Spain regarding 50 children in intensive care as a result of COVID-19 shows that 54 percent were affected by hyper-inflammatory conditions and 28 percent were on a ventilator. Those who needed a ventilator more often had an underlying disease (40), such as asthma and impaired immune systems.…”

Section: Risk Groups For More Serious Covid-19mentioning

confidence: 99%

Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden

2021

N Engl J Med

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“…In patients with non-multisystemic inflammatory syndrome in children (MIS-C) admitted in pediatric intensive care units in Brazil, median of leukocytes (per 1000/L) was 11,850 while in patients admitted with MIS-C was 18,275 12 . The values found in Spanish children also admitted in PICU was 9260 22 . Considering that our cases included patients admitted both in wards as in PICUs the values found were lower than reported by these authors.…”

Section: Discussionmentioning

confidence: 78%

Respiratory and non-respiratory manifestations in children admitted with COVID 19 in Rio de Janeiro city, Brazil

Silva

Fonseca

Miranda

et al. 2021

Preprint

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IntroductionCOVID 19 is still a challenge in pediatrics due to variety of symptoms and different presentationsAimTo describe clinical, laboratorial and treatment of confirmed COVID-19 pediatric admitted in hospitals.MethodsA retrospective study was conducted in children (0-18 years), admitted between March and November 15, 2020, with confirmed COVID-19 by reverse transcription polymerase chain reaction or serological tests. Clinical data about symptoms, laboratorial exams and treatments were analysed. Patients were evaluated according predominant (PRS) or non-predominant respiratory symptoms (non-PRS)ResultsSixty-four patients were evaluated, being the median age 5.6 years. Forty-seven (73.4%) children were admitted with PRS and 17 (26.4%) with non-PRS. The main symptoms in the PRS group were fever in 74.5% of children and cough in 66%; and fever in 76.5% and edema/cavitary effusion in 29.4% in the non-PRS group. The median of C-reactive protein (in mg/dl) was 2.5 in the PRS group and 6.1 in the non-PRS group. Antibiotics were used in 85.1% of the PRS group and 94.1% of non-group. Comorbidity was present in 30/47 (63.8%) of PRS group and 8/17 (47.1%) of non-PRS group (p=0.22). Length of stay until 7 days in patients with comorbidity was present in 27/64 (42.1%) and more than 7 days in 11/64 (17.1%) (p= 0.2)ConclusionNon-PRS represented more than one quarter of admitted patients. Fever was the main symptom detected, elevated CRP was frequent and antibiotics were commonly prescribed. Comorbidity was found in both groups and his presence was not associated with a longer length of stay.

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A multicenter national survey of children with SARS-CoV-2 infection admitted to Spanish Pediatric Intensive Care Units

Cited by 16 publications

References 4 publications

Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden

Respiratory and non-respiratory manifestations in children admitted with COVID 19 in Rio de Janeiro city, Brazil

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