Publication Date
8-16-2024
Journal
Clinical Infectious Diseases
DOI
10.1093/cid/ciae133
PMID
38465976
PMCID
PMC11327788
PubMedCentral® Posted Date
8-17-2024
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Humans, COVID-19, Child, Male, Female, Adolescent, Immunocompromised Host, Child, Preschool, Intensive Care Units, Pediatric, SARS-CoV-2, Infant, Hospitalization, United States, Hospital Mortality, immunocompromised host, pediatrics, critical care, bacterial coinfection
Abstract
BACKGROUND: 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.
METHODS: Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients(PICU) or high-acuity unit for acute COVID-19 were included.
RESULTS: Of 1274 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 = .005) and hospitalization was longer (P = .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 = .40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19.
CONCLUSIONS: In this national case series of patientscare, 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.
Included in
Biological Phenomena, Cell Phenomena, and Immunity Commons, Critical Care Commons, Diseases Commons, Medical Immunology Commons, Pediatrics Commons