Mortality in children with positive SARS-CoV-2 polymerase chain reaction test: Lessons learned from a tertiary referral hospital in Indonesia

Dewi, Rismala; Kaswandani, Nastiti; Karyanti, Mulya Rahma; Setyanto, Darmawan Budi; Pudjiadi, Antonius Hocky; Hendarto, Aryono; Djer, Mulyadi M.; Prayitno, Ari; Yuniar, Irene; Indawati, Wahyuni; Prawira, Yogi; Handryastuti, Setyo; Sjakti, Hikari Ambara; Hidayati, Eka Laksmi; Muktiarti, Dina; Soebadi, Amanda; Puspaningtyas, Niken Wahyu; Muhaimin, Riski; Rahmadhany, Anisa; Octavius, Gilbert Sterling; Puspitasari, Henny Adriani; Jasin, Madeleine Ramdhani; Tartila, Tartila; Putri, Nina Dwi

doi:10.1016/j.ijid.2021.04.019

Cited by 40 publications

(37 citation statements)

References 25 publications

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“…Aside from the low testing capability which results in the low number of positive cases (a smaller denominator would result in higher CFR), several other factors were identified. A previous study in the national referral hospital in Indonesia found that the CFR of COVID-19 in children was as high as 40% ( 12 ). This study described that children who came to the hospital were mostly those with severe to critical clinical conditions.…”

Section: Discussionmentioning

confidence: 98%

Pediatric COVID-19: Report From Indonesian Pediatric Society Data Registry

et al. 2021

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Background: Indonesia has a high number of COVID-19 cases and mortalities relative to not only among the Asia Pacific region but the world. Children were thought to be less affected by the virus compared to adults. Most of the public data reported combined data between adults and children. The Indonesian Pediatric Society (IPS) was involved in the COVID-19 response, especially in the area of child health. One of IPS's activities is collecting data registries from each of their chapters to provide a better understanding of COVID-19 in children.Objective: The objective of this study was to share the data of suspected and confirmed COVID-19 cases in children from IPS's COVID-19 data registry.Method: This is a retrospective study from the IPS's COVID-19 registry data. We collected the data of COVID-19 in children during March to December 2020 from each of the IPS chapters. We analyzed the prevalence, case fatality rate (CFR), age groups, diagnosis, and comorbidities of the children diagnosed with COVID-19.Result: As of December 21, 2020, there were 35,506 suspected cases of children with COVID-19. In total, there were 522 deaths, with a case fatality ratio (CFR) of 1.4. There were 37,706 confirmed cases with 175 fatalities (CFR 0.46). The highest mortality in confirmed COVID-19 cases was from children ages 10–18 years (42 out of 159 cases: 26%). The most common comorbidity and diagnosis found were malignancy (17.3%) and respiratory failure (54.5%).Conclusion: The CFR of confirmed COVID-19 cases in children in Indonesia is high and should be a major public concern.

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Section: Discussionmentioning

confidence: 98%

Pediatric COVID-19: Report From Indonesian Pediatric Society Data Registry

et al. 2021

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“…The remaining studies were from Brazil, Oman, Congo, Turkey, UK, Colombia, Kosovo, and Indonesia. Detailed data on the characteristics of the conclusive studies are given in Table S1 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nevertheless, more detailed evaluations are needed mainly for associated adverse events such as antimicrobial-induced acute kidney injuries in critical care settings [ 61 ]. Moreover, there is a difference in reporting mortality rates from previously reviewed studies covering a wide range between 0% and 100% of the ICU patients [ 28 , 34 , 45 ] (see Table S1 ). This mortality rate variation appeared to be affected by various clinical and social factors, such as age, comorbidities, regional COVID-19 pandemic situation, and timely access to optimal healthcare [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotics Prescribing in Intensive Care Settings during the COVID-19 Era: A Systematic Review

Abu-Rub

Abdelrahman

Johar³

et al. 2021

Antibiotics

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The prevalence of patients admitted to intensive care units (ICUs) with SARS-CoV-2 infection who were prescribed antibiotics is undetermined and might contribute to the increased global antibiotic resistance. This systematic review evaluates the prevalence of antibiotic prescribing in patients admitted to ICUs with SARS-CoV-2 infection using PRISMA guidelines. We searched and scrutinized results from PubMed and ScienceDirect databases for published literature restricted to the English language up to 11 May 2021. In addition, we included observational studies of humans with laboratory-confirmed SARS-CoV-2 infection, clinical characteristics, and antibiotics prescribed for ICU patients with SARS-CoV-2 infections. A total of 361 studies were identified, but only 38 were included in the final analysis. Antibiotic prescribing data were available from 2715 patients, of which prevalence of 71% was reported in old age patients with a mean age of 62.7 years. From the reported studies, third generation cephalosporin had the highest frequency amongst reviewed studies (36.8%) followed by azithromycin (34.2%). The estimated bacterial infection in 12 reported studies was 30.8% produced by 15 different bacterial species, and S. aureus recorded the highest bacterial infection (75%). The fundamental outcomes were the prevalence of ICU COVID-19 patients prescribed antibiotics stratified by age, type of antibiotics prescribed, and the presence of co-infections and comorbidities. In conclusion, more than half of ICU patients with SARS-CoV-2 infection received antibiotics, and prescribing is significantly higher than the estimated frequency of identified bacterial co-infection.

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“…The Coronavirus Disease (COVID-19) caused by a novel zoonotic coronavirus (SARS-CoV-2) emerged from Wuhan, China and rapidly escalated into a global pandemic. A systematic review conducted by Christophers et al revealed that the majority of children with SARS-CoV-2 presented with either no symptoms or a single symptom, with 75% of asymptomatic children exhibiting abnormal chest radiography or computed tomography findings [1] .…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Pediatric Germinoma With SARS-CoV-2: Lessons Learned From an Academic Tertiary Referral Hospital in Asian COVID Epicentrum

Rahmadhan

Parenrengi

Suryaningtyas

2022

International Journal of Surgery Case Reports

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Background Patients often present with one or more pre-existing underlying chronic diseases that will affect their prognoses and mortality. A study revealed that the majority of children with SARS-CoV-2 infection presented with either no or a single symptom. Meanwhile, multiple other studies reported of more severe disease in SARS-CoV-2 infected children with brain tumor and/or cancer as a whole. Case report The patient was a 15-year-old male who was referred to our hospital with complaints of vomiting, headache, and signs of worsening right hemiparesis. Initial MRI suggested of a high-grade astrocytoma and hydrocephalus, but a subtotal tumor resection and external ventricular drainage gave light to a histopathological examination conclusive of germinoma. After adhering to radiotherapy and recovering well, the patient fell into unconsciousness 9 months later and tested positive for SARS-CoV-2 infection. The patient deteriorated on the third day of admission with respiratory failure, shock, arrythmias, fever, and increased d-dimer. After multiple attempts stabilization with ventilatory, defibrillator, and medical support, the patient deceased at the 6th day of admission. Discussion Cancer patients with COVID-19 have been reported to have relatively higher mortality rate when compared to the non-infected patients. Moreover, malignancies were also reported to increase the risk of developing more severe disease in children. Although rare, patients may develop a condition called multisystem inflammatory syndrome in children (MIS-C), which is a state of hyperinflammatory and severe illness temporally associated with COVID-19 infection. No observations have been evident in indicating the influence of COVID-19 on the neurological state of the patient, but we believe that it may be reasonable to not yet exclude the possibility of it of exacerbating the CNS malignancy our patient suffered from. Conclusion Children with intracranial brain tumor infected by SARS-CoV-2 may fall into a worse condition with poor prognosis, exacerbated by severe acute respiratory distress and the need for breathing support in intensive care unit. Multidisciplinary tumor boards have to convene regularly, including through call-conferences and telemedicine platforms.

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Mortality in children with positive SARS-CoV-2 polymerase chain reaction test: Lessons learned from a tertiary referral hospital in Indonesia

Cited by 40 publications

References 25 publications

Pediatric COVID-19: Report From Indonesian Pediatric Society Data Registry

Pediatric COVID-19: Report From Indonesian Pediatric Society Data Registry

Antibiotics Prescribing in Intensive Care Settings during the COVID-19 Era: A Systematic Review

A Case Report of Pediatric Germinoma With SARS-CoV-2: Lessons Learned From an Academic Tertiary Referral Hospital in Asian COVID Epicentrum

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