Division of Critical Care, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Division of Pulmonary Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Pediatr Pulmonol. 2021 Dec;56(12):3960-3965. doi: 10.1002/ppul.25650. Epub 2021 Sep 10.
The global COVID-19 pandemic was particularly concerning for the pediatric pulmonary hypertension (PH) population due to immature immune systems and developmental comorbidities. This study aims to describe a single-center experience of pediatric PH patients diagnosed with COVID-19 disease.
A retrospective cohort study of all pediatric patients followed by the PH Center at Texas Children's Hospital diagnosed with COVID-19 infection from April 2020 to February 2021.
We identified 23 patients with a median age of 58 months (interquartile range [IQR]: 25-75th, 21-132 months), 48% being Hispanics. Eight patients (35%) required hospitalization; median length of stay was 6 days (IQR: 25-75th, 5-8 days). Only three of these eight patients required increased respiratory support. Targeted PH therapy was escalated in four patients (two in dual and two in triple therapy). There was one mortality in a patient with failing Fontan physiology. Ninety-one percent of patients have had post-COVID outpatient follow-up, median of 101 days (IQR: 25-75th, 50-159 days) from diagnosis. Of the five patients with 6 min walk test (6MWT) data, three (60%) children walked less distance, median of -12 m (IQR: 25-75th, -12 to +49 m) compared to pre-COVID testing. Postinfection pulmonary function testing (PFT) was notable for decrease in predicted forced vital capacity (FVC; median -6%, range -11% to +6%) and forced expiratory volume in one second (FEV1; median -14%, range -12% to -18%) in 75% of the patients with PFT data.
In our institution, COVID-19 was found more frequently in Hispanics and associated with low mortality.
由于免疫系统不成熟和发育合并症，全球 COVID-19 大流行对儿科肺动脉高压（PH）患者群体尤为令人担忧。本研究旨在描述一家单中心的儿科 PH 患者确诊 COVID-19 疾病的经历。
这是一项回顾性队列研究，纳入了 2020 年 4 月至 2021 年 2 月期间在德克萨斯儿童医学中心 PH 中心就诊并被诊断为 COVID-19 感染的所有儿科患者。
我们确定了 23 例患者，中位年龄为 58 个月（四分位距 [IQR]：25-75 分位，21-132 个月），48%为西班牙裔。8 例（35%）患者需要住院治疗；中位住院时间为 6 天（IQR：25-75 分位，5-8 天）。这 8 例患者中仅 3 例需要增加呼吸支持。4 例患者（2 例接受双重治疗，2 例接受三重治疗）上调了靶向 PH 治疗。1 例心功能衰竭患者死亡。91%的患者在 COVID 后进行了门诊随访，从诊断到随访的中位时间为 101 天（IQR：25-75 分位，50-159 天）。在有 6 分钟步行试验（6MWT）数据的 5 例患者中，有 3 例（60%）儿童的步行距离减少，中位距离为-12m（IQR：25-75 分位，-12 至+49m）与 COVID 前的测试相比。75%的患者有肺功能检测（PFT）数据，结果显示感染后用力肺活量（FVC；中位数下降 6%，范围为-11%至+6%）和一秒用力呼气容积（FEV1；中位数下降 14%，范围为-12%至-18%）均有下降。
在我们的机构中，COVID-19 在西班牙裔中更为常见，且死亡率较低。
