Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

被引:7
|
作者
Maddux, Aline B. [1 ,2 ]
Young, Cameron C. [3 ]
Kucukak, Suden [3 ]
Zambrano, Laura D. [4 ]
Newhams, Margaret M. [3 ]
Rollins, Caitlin K. [5 ,6 ]
Halasa, Natasha B. [7 ]
Gertz, Shira J. [8 ]
Mack, Elizabeth H. [9 ]
Schwartz, Stephanie [10 ]
Kong, Michele [11 ]
Loftis, Laura L. [12 ]
Irby, Katherine [13 ]
Rowan, Courtney M. [14 ]
Tarquinio, Keiko M. [15 ]
Zinter, Matt S. [16 ]
Crandall, Hillary [17 ]
Cvijanovich, Natalie Z. [18 ]
Schuster, Jennifer E. [19 ]
Fitzgerald, Julie C. [20 ]
Staat, Mary A. [21 ]
Hobbs, Charlotte V. [22 ]
Nofziger, Ryan A. [23 ]
Shein, Steven [24 ]
Flori, Heidi [25 ,26 ]
Cullimore, Melissa L. [27 ]
Chatani, Brandon M. [28 ]
Levy, Emily R. [29 ]
Typpo, Katri V. [30 ]
Hume, Janet R. [31 ]
Campbell, Angela P.
Randolph, Adrienne G. [32 ]
机构
[1] Univ Colorado, Sch Med, Dept Pediat, Sect Crit Care Med, Aurora, CO 80045 USA
[2] Childrens Hosp Colorado, Aurora, CO 80045 USA
[3] Boston Childrens Hosp, Dept Anesthesiol, Crit Care & Pain Med, Boston, MA USA
[4] CDCP, COVID 19 Response, Atlanta, GA USA
[5] Boston Childrens Hosp, Dept Neurol, Boston, MA USA
[6] Harvard Med Sch, Boston, MA 02115 USA
[7] Vanderbilt Univ, Med Ctr, Dept Pediat, Div Pediat Infect Dis, Nashville, TN 37232 USA
[8] Cooperman Barnabas Med Ctr, Div Pediat Crit Care, Dept Pediat, Livingston, NJ USA
[9] Med Univ South Carolina, Div Pediat Crit Care Med, Charleston, SC USA
[10] Univ North Carolina Chapel Hill, Dept Pediat, Chapel Hill, NC USA
[11] Univ Alabama Birmingham, Dept Pediat, Div Pediat Crit Care Med, Birmingham, AL USA
[12] Texas Childrens Hosp, Dept Pediat, Sect Crit Care Med, Houston, TX USA
[13] Arkansas Childrens Hosp, Dept Pediat, Sect Pediat Crit Care, Little Rock, AR USA
[14] Indiana Univ Sch Med, Riley Hosp Children, Dept Pediat, Div Pediat Crit Care Med, Indianapolis, IN USA
[15] Emory Univ, Dept Pediat, Div Crit Care Med, Childrens Healthcare Atlanta,Sch Med, Atlanta, GA USA
[16] Univ Calif San Francisco, Dept Pediat, Div Crit Care, San Francisco, CA USA
[17] Univ Utah, Dept Pediat, Div Pediat Crit Care, Primary Childrens Hosp, Salt Lake City, UT USA
[18] UCSF Benioff Childrens Hosp, Div Crit Care Med, Oakland, CA USA
[19] Childrens Mercy Kansas City, Dept Pediat, Div Pediat Infect Dis, Kansas City, MO USA
[20] Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Dept Anesthesiol & Crit Care, Philadelphia, PA USA
[21] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Infect Dis, Cincinnati, OH USA
[22] Univ Mississippi, Med Ctr, Dept Pediat, Div Infect Dis, Jackson, MS 39216 USA
[23] Akron Childrens Hosp, Div Crit Care Med, Akron, OH USA
[24] Rainbow Babies & Childrens Hosp, Div Pediat Crit Care Med, Cleveland, OH USA
[25] CS Mott Childrens Hosp, Dept Pediat, Div Pediat Crit Care Med, Ann Arbor, MI USA
[26] Univ Michigan, Ann Arbor, MI 48109 USA
[27] Childrens Hosp & Med Ctr, Dept Pediat, Div Pediat Crit Care, Omaha, NE USA
[28] AdventHlth Children, Dept Pediat, Div Pediat Infect Dis, Orlando, FL USA
[29] Mayo Clin, Dept Pediat & Adolescent Med, Div Pediat Infect Dis, Div Pediat Crit Care Med, Rochester, MN USA
[30] Univ Arizona, Diamond Childrens Banner Childrens Med Ctr, Tucson, AZ USA
[31] Univ Minnesota, Masonic Childrens Hosp, Div Pediat Crit Care, Minneapolis, MN USA
[32] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA
来源
FRONTIERS IN PEDIATRICS | 2023年 / 11卷
关键词
post-acute COVID-19 syndrome; COVID-19 post-intensive care syndrome; critical care outcomes; SARS-CoV-2; multisystem inflammatory syndrome in children; MIS-C; COVID-19; pediatrics; OUTCOMES; CARE; PEDSQL(TM)-4.0; RELIABILITY;
D O I
10.3389/fped.2023.1260372
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments.Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for >= 2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.
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页数:11
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