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1. Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting

Author

Emmerson C. F. de Farias, Manoel J. C. Pavão Junior, Susan C. D. de Sales, Luciana M. P. P. do Nascimento, Dalila C. A. Pavão, Anna P. S. Pinheiro, Andreza H. O. Pinheiro, Marília C. B. Alves, Kíssila M. M. M. Ferraro, Larisse F. Q. Aires, Luana G. Dias, Mayara M. M. Machado, Michaelle J. D. Serrão, Raphaella R. Gomes, Sara M. P. de Moraes, Gabriella M. G. Moura, Adriana M. B. de Sousa, Gabriela C. L. Pontes, Railana D. F. P. Carvalho, Cristiane T. C. Silva, Guilherme Lemes, Bruna da C. G. Diniz, Aurimery G. Chermont, Kellen F. S. de Almeida, Salma B. Saraty, Mary L. F. Maia, Miriam R. C. Lima, Patricia B. Carvalho, Renata de B. Braga, Kathia de O. Harada, Maria C. A. Justino, Gleice Clemente, Maria Teresa Terreri, and Marta C. Monteiro

Subjects
SARS-CoV-2 virus, Intensive Care Unit, Pediatric, Child health, Risk factor, Mortality, Medicine, Science
Abstract

Abstract SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo–18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2–28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3–202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4–13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization.

Published
2024
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2. Multisystem Inflammatory Syndrome Associated With Coronavirus Disease in Children

Author

Marilia L. M Cotta, Emmerson Carlos Franco de Farias, Luciana Maria Passos Pinto do Nascimento, Salma B Saraty, Mayara Márvia Matias Machado, Ana R. G Pedreira, Railana D. F. P Carvalho, Larisse F. Q Aires, Mary Lucy Ferraz Maria Fiuza de Mello, Jefferson Pedro Piva, Thatiane da S Rodrigues, Miriam C Lima, Maria Cleonice Aguiar Justino, Carina C Costa, and Marília C. B Alves

Subjects
Microbiology (medical), Pediatrics, medicine.medical_specialty, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pandemias / hist?ria, Disease, S?ndrome Respirat?ria Aguda Grave, medicine.disease_cause, Betacoronavirus, Estudo Multic?ntrico, 03 medical and health sciences, 0302 clinical medicine, hemic and lymphatic diseases, 030225 pediatrics, medicine, 030212 general & internal medicine, skin and connective tissue diseases, Prospective cohort study, Coronavirus, business.industry, V?rus da SARS / patogenicidade, Mortality rate, Covid - 19, medicine.disease, humanities, Infec??es por Coronavirus / patogenicidade, Infectious Diseases, Shock (circulatory), Pediatrics, Perinatology and Child Health, Hospital admission, Kawasaki disease, medicine.symptom, business, geographic locations
Abstract

Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil / Metropolitan University Center of the Amazon. Department of child health. Bel?m, PA, Brazil. Universidade Federal do Rio Grande do Sul. Department of Pediatrics. Division of Pediatric Intensive Care. Porto Alegre, RS, Brazil. Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil. Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil Funda??o Santa Casa de Miseric?rdia do Par? Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil Funda??o Hospital das Cl?nicas Gaspar Viana?s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil. Pr?-Infantil?s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil. Pronto Socorro Municipal M?rio Pinotti?s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil. Pronto Socorro Municipal M?rio Pinotti?s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Bel?m, PA, Brazil. Universidade Federal do Rio Grande do Sul. Department of Pediatrics. Division of Pediatric Intensive Care. Porto Alegre, RS, Brazil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. We described the characteristics of 11 children with pediatric multisystem inflammatory syndrome-temporally associated with SARS-CoV-2. The main clinical indications for hospital admission were vasogenic toxic shock (n = 2), Kawasaki disease (n = 4), and Kawasaki disease shock syndrome (n = 5). The echocardiography findings were abnormal in 63% of cases. All patients had 2 or more organ dysfunctions, and the mortality rate was 18%.

Published
2020
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3. Multisystem Inflammatory Syndrome Associated With Coronavirus Disease in Children: A Multi-centered Study in Belém, Pará, Brazil

Author

Emmerson C F, de Farias, Jefferson, Pedro Piva, Mary L F M F, de Mello, Luciana M P P, do Nascimento, Carina C, Costa, Mayara M M, Machado, Thatiane da S, Rodrigues, Railana D F P, Carvalho, Marília C B, Alves, Larisse F Q, Aires, Marilia L M, Cotta, Ana R G, Pedreira, Salma B, Saraty, Miriam C, Lima, and Maria C A, Justino

Subjects
Male, Adolescent, SARS-CoV-2, Pneumonia, Viral, Infant, Newborn, COVID-19, Infant, Mucocutaneous Lymph Node Syndrome, Systemic Inflammatory Response Syndrome, Betacoronavirus, Child, Preschool, Humans, Female, Prospective Studies, Mortality, Child, Coronavirus Infections, Pandemics, Brazil
Abstract

We described the characteristics of 11 children with pediatric multisystem inflammatory syndrome-temporally associated with SARS-CoV-2. The main clinical indications for hospital admission were vasogenic toxic shock (n = 2), Kawasaki disease (n = 4), and Kawasaki disease shock syndrome (n = 5). The echocardiography findings were abnormal in 63% of cases. All patients had 2 or more organ dysfunctions, and the mortality rate was 18%.

Published
2020

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