1. Severe and fatal forms of COVID-19 in children
- Author
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Mehdi Oualha, Elodie Salvador, M. Vedrenne, L. de Saint Blanquat, L. Dupic, F. Lesage, C. Heilbronner, Alice Corsia, David Drummond, Florence Moulin, C. de Marcellus, M. Bendavid, G. Chéron, Y. Pinhas, Marion Grimaud, Romain Berthaud, Judith Chareyre, François Angoulvant, Jacques Fourgeaud, Laureline Berteloot, Sylvain Renolleau, Julie Toubiana, Pierre Frange, M. Castelle, Université de Paris (UP), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université Paris Cité (UPC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)
- Subjects
Male ,Paris ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Pneumonia, Viral ,coronavirus ,India ,Comorbidity ,Disease ,Severity of Illness Index ,Article ,Betacoronavirus ,03 medical and health sciences ,COVID-19 Testing ,0302 clinical medicine ,Risk Factors ,030225 pediatrics ,medicine ,Extracorporeal membrane oxygenation ,Humans ,Pediatrics, Perinatology, and Child Health ,030212 general & internal medicine ,Renal replacement therapy ,Disease management (health) ,Child ,Pandemics ,Demography ,Retrospective Studies ,Mechanical ventilation ,Past medical history ,Clinical Laboratory Techniques ,SARS-CoV-2 ,business.industry ,COVID-19 ,Infant ,Prognosis ,3. Good health ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Disease Progression ,Female ,Observational study ,Coronavirus Infections ,business ,Scientific Letter - Abstract
Objectives The aim of this study was to describe severe forms of novel coronavirus disease 2019 in children, including patient characteristics, clinical, laboratory, and imaging findings, as well as the disease management and outcomes. Methods This was a retrospective, single-center, observational study conducted in a pediatric intensive and high-dependency care unit (PICU, HDU) in an urban hospital in Paris. All patients, aged from 1 month to 18 years, admitted for confirmed or highly suspected SARS-CoV-2 were included. Results We analyzed the data of 27 children. Comorbidities (n = 19, 70%) were mainly neurological (n = 7), respiratory, (n = 4), or sickle cell disease (n = 4). SARS-CoV-2 PCR results were positive in 24 children (nasopharyngeal swabs). The three remaining children had a chest CT scan consistent with COVID-19. Respiratory involvement was observed in 24 patients (89%). Supportive treatments were invasive mechanical ventilation (n = 9), catecholamine (n = 4), erythropheresis (n = 4), renal replacement therapy (n = 1), and extracorporeal membrane oxygenation (n = 1). Five children died, of whom three were without past medical history. Conclusion This study highlighted the large spectrum of clinical presentation and time course of disease progression as well as the non-negligible occurrence of pediatric life-threatening and fatal cases of COVID-19 mostly in patients with comorbidities. Additional laboratory investigations are needed to further analyze the mechanism underlying the variability of SARS-Cov-2 pathogenicity in children.
- Published
- 2020