Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey;
Hackensack Meridian School of Medicine, Nutley, New Jersey.
Hosp Pediatr. 2021 Jan;11(1):79-87. doi: 10.1542/hpeds.2020-001719.
Understanding the risk factors, predictors, and clinical presentation of coronavirus disease 2019 (COVID-19) in pediatric patients with severe disease.
We conducted a retrospective chart review of pediatric patients admitted between March 1, 2020, and May 31, 2020, to a large health network in New Jersey with positive test results for severe acute respiratory syndrome coronavirus 2 on reverse transcriptase polymerase chain reaction, rapid testing, or serum immunoglobulin G testing; we included demographic characteristics, clinical features, and outcomes.
A total of 81 patients ≤21 years old were admitted with positive test results for severe acute respiratory syndrome coronavirus 2 on reverse transcriptase polymerase chain reaction and/or serum immunoglobulin testing. Sixty-seven patients (82.7%) were admitted for management of acute COVID-19 infection, whereas 14 (17.3%) were admitted for management of multisystem inflammatory syndrome in children (MIS-C). Of the 81 hospitalized patients, 28 (34.6%) required intensive care. A majority of patients (42 [51.9%]) admitted for both acute COVID-19 infection and MIS-C were Hispanic. Underlying chronic health conditions were not present in most patients. Obesity (mean BMI of 41.1) was noted in the patients with MIS-C requiring ICU care, although not statistically significant. Absolute lymphopenia and elevated levels of inflammatory markers were statistically significant in the patients with MIS-C treated in the ICU.
This study adds to the growing literature of potential risk factors for severe disease in pediatric patients due to COVID-19 infection and MIS-C. Patients of Hispanic ethnicity represented the majority of patients with both acute COVID-19 infection and MIS-C, despite only representing 10% to 20% of the population our hospitals serve. Infants and patients with chronic health conditions were not at increased risk for severe disease. Absolute lymphopenia and elevated levels of inflammatory markers were associated with more severe disease.
了解儿童重症 COVID-19 患者的危险因素、预测因素和临床表现。
我们对 2020 年 3 月 1 日至 5 月 31 日期间在新泽西州一家大型医疗网络中因严重急性呼吸综合征冠状病毒 2 （SARS-CoV-2）的逆转录酶聚合酶链反应、快速检测或血清免疫球蛋白 G 检测呈阳性而住院的 81 例年龄≤21 岁的患儿进行回顾性病历分析，纳入人口统计学特征、临床特征和结局。
共有 81 例患儿因 SARS-CoV-2 的逆转录酶聚合酶链反应和/或血清免疫球蛋白检测呈阳性而住院。67 例（82.7%）因急性 COVID-19 感染接受治疗，14 例（17.3%）因儿童多系统炎症综合征（MIS-C）接受治疗。81 例住院患儿中，28 例（34.6%）需要重症监护。因急性 COVID-19 感染和 MIS-C 而住院的大多数患儿（42 [51.9%]）为西班牙裔。大多数患儿（72 [90.1%]）无基础慢性健康疾病。在需要 ICU 治疗的 MIS-C 患儿中观察到肥胖（平均 BMI 为 41.1），但无统计学意义。在 ICU 治疗的 MIS-C 患儿中，绝对淋巴细胞减少和炎症标志物水平升高具有统计学意义。
本研究增加了有关 COVID-19 感染和 MIS-C 导致儿童重症的潜在危险因素的文献资料。尽管西班牙裔患儿仅占我们医院服务人群的 10%至 20%，但他们在急性 COVID-19 感染和 MIS-C 患儿中占大多数。婴儿和患有慢性健康疾病的患儿发生重症疾病的风险没有增加。绝对淋巴细胞减少和炎症标志物水平升高与更严重的疾病相关。
