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Impact of SARS-CoV-2 Infection on the Association Between Laboratory Tests and Severe Outcomes Among Hospitalized Children.

Authors :
Xie, Jianling
Kuppermann, Nathan
Florin, Todd A
Tancredi, Daniel J
Funk, Anna L
Kim, Kelly
Salvadori, Marina I
Yock-Corrales, Adriana
Shah, Nipam P
Breslin, Kristen A
Chaudhari, Pradip P
Bergmann, Kelly R
Ahmad, Fahd A
Nebhrajani, Jasmine R
Mintegi, Santiago
Gangoiti, Iker
Plint, Amy C
Avva, Usha R
Gardiner, Michael A
Malley, Richard
Source :
Open Forum Infectious Diseases; Oct2023, Vol. 10 Issue 10, p1-10, 10p
Publication Year :
2023

Abstract

Background To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–infected children and determined if SARS-CoV-2 test result status modified the associations. Methods We conducted a cross-sectional analysis of participants tested for SARS-CoV-2 infection in 41 pediatric emergency departments in 10 countries. Participants were hospitalized, had laboratory testing performed, and completed 14-day follow-up. The primary objective was to assess the associations between laboratory findings and severe outcomes. The secondary objective was to determine if the SARS-CoV-2 test result modified the associations. Results We included 1817 participants; 522 (28.7%) SARS-CoV-2 test-positive and 1295 (71.3%) test-negative. Seventy-five (14.4%) test-positive and 174 (13.4%) test-negative children experienced severe outcomes. In regression analysis, we found that among SARS-CoV-2-positive children, procalcitonin ≥0.5 ng/mL (adjusted odds ratio [aOR], 9.14; 95% CI, 2.90–28.80), ferritin >500 ng/mL (aOR, 7.95; 95% CI, 1.89–33.44), D-dimer ≥1500 ng/mL (aOR, 4.57; 95% CI, 1.12–18.68), serum glucose ≥120 mg/dL (aOR, 2.01; 95% CI, 1.06–3.81), lymphocyte count <1.0 × 10<superscript>9</superscript>/L (aOR, 3.21; 95% CI, 1.34–7.69), and platelet count <150 × 10<superscript>9</superscript>/L (aOR, 2.82; 95% CI, 1.31–6.07) were associated with severe outcomes. Evaluation of the interaction term revealed that a positive SARS-CoV-2 result increased the associations with severe outcomes for elevated procalcitonin, C-reactive protein (CRP), D-dimer, and for reduced lymphocyte and platelet counts. Conclusions Specific laboratory parameters are associated with severe outcomes in SARS-CoV-2-infected children, and elevated serum procalcitonin, CRP, and D-dimer and low absolute lymphocyte and platelet counts were more strongly associated with severe outcomes in children testing positive compared with those testing negative. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
23288957
Volume :
10
Issue :
10
Database :
Complementary Index
Journal :
Open Forum Infectious Diseases
Publication Type :
Academic Journal
Accession number :
173588564
Full Text :
https://doi.org/10.1093/ofid/ofad485