Journal article
Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care
Clinical infectious diseases, Vol.79(2), pp.395-404
03/11/2024
DOI: 10.1093/cid/ciae133
PMCID: PMC11327788
PMID: 38465976
Abstract
We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care.
55 hospitals in 30 U.S. states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted March 12, 2020-December 30, 2021 to the pediatric intensive care unit (PICU) or high acuity unit for acute COVID-19 were included.
Of 1,274 patients, 105 (8.2%) had an ICC including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid organ transplantation, 16 (15.2%) solid tumors and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs. 4.6%, p = 0.005) and hospitalization was longer (p = 0.01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, p = 0.40). In patients with ICC, bacterial co-infection was more common in those with life-threatening COVID-19.
In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities.
Details
- Title: Subtitle
- Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care
- Creators
- Courtney M Rowan - Riley Hospital for ChildrenBrenna LaBere - Boston Children's HospitalCameron C Young - Boston Children's HospitalLaura D Zambrano - Centers for Disease Control and PreventionMargaret M Newhams - Boston Children's HospitalSuden Kucukak - Boston Children's HospitalElizabeth R McNamara - Boston Children's HospitalElizabeth H Mack - Medical University of South CarolinaJulie C Fitzgerald - Children's Hospital of PhiladelphiaKatherine Irby - Arkansas Children's HospitalAline B Maddux - Children's Hospital ColoradoJennifer E Schuster - Children's Mercy HospitalMichele Kong - University of Alabama at BirminghamHeda Dapul - NYU Langone HealthStephanie P Schwartz - University of North Carolina at Chapel HillMelania M Bembea - Johns Hopkins MedicineLaura L Loftis - Baylor College of MedicineAmanda R Kolmar - Washington University in St. LouisChristopher J Babbitt - Miller Children's & Women's HospitalRyan A Nofziger - Akron Children's HospitalMark W Hall - Nationwide Children's HospitalShira J Gertz - Saint Barnabas Medical CenterNatalie Z Cvijanovich - UCSF Benioff Children's HospitalMatt S Zinter - University of California, San FranciscoNatasha B Halasa - Vanderbilt University Medical CenterTamara T Bradford - Louisiana State UniversityGwenn E McLaughlin - University of MiamiAalok R Singh - Westchester Medical CenterCharlotte V Hobbs - University of Mississippi Medical CenterKari Wellnitz - University of IowaMary A Staat - Cincinnati Children's Hospital Medical CenterBria M Coates - Northwestern UniversityHillary R Crandall - University of UtahMia Maamari - The University of Texas Southwestern Medical CenterKevin M Havlin - University of LouisvilleAdam J Schwarz - Children's Hospital of Orange CountyChristopher L Carroll - Connecticut Children's Medical CenterEmily R Levy - Mayo Clinic in FloridaKristin L Moffitt - Boston Children's HospitalAngela P Campbell - Centers for Disease Control and PreventionAdrienne G Randolph - Harvard UniversityJanet Chou - Boston Children's HospitalOvercoming COVID-19 Investigators
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.79(2), pp.395-404
- DOI
- 10.1093/cid/ciae133
- PMID
- 38465976
- PMCID
- PMC11327788
- NLM abbreviation
- Clin Infect Dis
- eISSN
- 1537-6591
- Grant note
- DOI: 10.13039/100000030, name: US Centers for Disease Control and Prevention; DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: K23HL150244
- Language
- English
- Electronic publication date
- 03/11/2024
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics
- Record Identifier
- 9984572460102771
Metrics
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