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印度 COVID-19 大流行第一波和第二波期间,收治于一家三级医院的 SARS-CoV-2 感染患儿的流行病学、临床特征、重症监护需求和结局。

Epidemiology, Clinical Profile, Intensive Care Needs and Outcome in Children with SARS-CoV-2 Infection Admitted to a Tertiary Hospital During the First and Second Waves of the COVID-19 Pandemic in India.

机构信息

Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

Division of Pediatric Pulmonology, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

出版信息

Indian J Pediatr. 2023 Feb;90(2):131-138. doi: 10.1007/s12098-022-04283-0. Epub 2022 Aug 3.

Abstract

OBJECTIVES

To compare the epidemiological, clinical profile, intensive care needs and outcome of children hospitalized with SARS-CoV-2 infection during the first and second waves of the pandemic.

METHODS

This was a retrospective study of all children between 1 mo and 14 y, admitted to a dedicated COVID-19 hospital (DCH) during the first (1st June to 31st December 2020) and second waves (1st March to 30th June 2021).

RESULTS

Of 217 children, 104 (48%) and 113 (52%) were admitted during the first and second waves respectively. One hundred fifty-two (70%) had incidentally detected SARS-CoV-2 infection, while 65 (30%) had symptomatic COVID-19. Comorbidities were noted in 137 (63%) children. Fifty-nine (27%) and 66 (30%) children required high-dependency unit (HDU) and ICU care respectively. Severity of infection and ICU needs were similar during both waves. High-flow oxygen (n = 5, 2%), noninvasive ventilation [CPAP (n = 34, 16%) and BiPAP (n = 8, 5%)] and invasive ventilation (n = 45, 21%) were respiratory support therapies needed. NIV use was more during the second wave (26% vs. 13%; p = 0.02). The median (IQR) length (days) of DCH stay among survivors was longer during the first wave [8 (6-10) vs. 5.5 (3-8); p = 0.0001].

CONCLUSIONS

Disease severity, associated comorbidities, PICU and organ support need and mortality were similar in the first and second waves of the pandemic. Children admitted during the second wave were younger, had higher proportion of NIV use and shorter length of COVID-19 hospital stay.

摘要

目的

比较儿童在大流行第一波和第二波期间因 SARS-CoV-2 感染住院的流行病学、临床特征、重症监护需求和结局。

方法

这是一项对在专门的 COVID-19 医院(DCH)住院的第一波(2020 年 6 月 1 日至 12 月 31 日)和第二波(2021 年 3 月 1 日至 6 月 30 日)期间的所有 1 个月至 14 岁儿童进行的回顾性研究。

结果

217 名儿童中,第一波和第二波分别有 104 名(48%)和 113 名(52%)儿童入院。152 名(70%)为偶然检测到 SARS-CoV-2 感染,65 名(30%)为有症状 COVID-19。137 名(63%)儿童有合并症。59 名(27%)和 66 名(30%)儿童分别需要高度依赖单位(HDU)和 ICU 护理。两波之间感染的严重程度和 ICU 需求相似。高流量氧气(n=5,2%)、无创通气[CPAP(n=34,16%)和 BiPAP(n=8,5%)]和有创通气(n=45,21%)是需要的呼吸支持治疗。第二波中 NIV 的使用率更高(26%比 13%;p=0.02)。幸存者在 DCH 的中位(IQR)住院时间在第一波更长[8(6-10)比 5.5(3-8);p=0.0001]。

结论

在大流行的第一波和第二波中,疾病严重程度、相关合并症、PICU 和器官支持需求以及死亡率相似。第二波入院的儿童年龄较小,NIV 的使用率更高,COVID-19 医院的住院时间更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd66/9362352/7914e9e912c6/12098_2022_4283_Fig1_HTML.jpg

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