Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico.
Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico.
Front Public Health. 2022 Dec 16;10:969251. doi: 10.3389/fpubh.2022.969251. eCollection 2022.
The new coronavirus SARS-CoV-2 pandemic has been relatively less lethal in children; however, poor prognosis and mortality has been associated with factors such as access to health services. Mexico remained on the list of the ten countries with the highest case fatality rate (CFR) in adults. It is of interest to know the behavior of COVID-19 in the pediatric population. The aim of this study was to identify clinical and sociodemographic variables associated with mortality due to COVID-19 in pediatric patients.
Using National open data and information from the Ministry of Health, Mexico, this cohort study aimed to identify clinical and sociodemographic variables associated with COVID-19 mortality in pediatric patients.
A cohort study was designed based on National open data from the Ministry of Health, Mexico, for the period April 2020 to January 2022, and included patients under 18 years of age with confirmed SARS-CoV-2 infection. Variables analyzed were age, health services used, and comorbidities (obesity, diabetes, asthma, cardiovascular disease, immunosuppression, high blood pressure, and chronic kidney disease). Follow-up duration was 60 days, and primary outcomes were death, hospitalization, and requirement of intensive care. Statistical analysis included survival analysis, prediction models created using the Cox proportional hazards model, and Kaplan-Meier estimation curves.
The cohort included 261,099 cases with a mean age of 11.2 ± 4 years, and of these, 11,569 (4.43%) were hospitalized and 1,028 (0.39%) died. Variables associated with risk of mortality were age under 12 months, the presence of comorbidities, health sector where they were treated, and first wave of infection.
Based on data in the National database, we show that the pediatric fatality rate due to SARS-CoV-2 is similar to that seen in other countries. Access to health services and distribution of mortality were heterogeneous. Vulnerable groups were patients younger than 12 months and those with comorbidities.
新型冠状病毒 SARS-CoV-2 大流行在儿童中相对致命性较低；然而，预后不良和死亡率与获得医疗服务等因素有关。墨西哥仍在成人发病率最高的十个国家之列。了解 COVID-19 在儿科人群中的表现是很有意义的。本研究的目的是确定与 COVID-19 儿科患者死亡相关的临床和社会人口学变量。
本队列研究使用墨西哥卫生部的国家公开数据和信息，旨在确定与 COVID-19 儿科患者死亡相关的临床和社会人口学变量。
设计了一项基于墨西哥卫生部国家公开数据的队列研究，研究时间为 2020 年 4 月至 2022 年 1 月，纳入年龄在 18 岁以下且确诊 SARS-CoV-2 感染的患者。分析的变量包括年龄、使用的医疗服务以及合并症（肥胖、糖尿病、哮喘、心血管疾病、免疫抑制、高血压和慢性肾脏病）。随访时间为 60 天，主要结局为死亡、住院和需要重症监护。统计分析包括生存分析、使用 Cox 比例风险模型创建预测模型和 Kaplan-Meier 估计曲线。
该队列包括 261099 例病例，平均年龄为 11.2 ± 4 岁，其中 11569 例（4.43%）住院，1028 例（0.39%）死亡。与死亡风险相关的变量包括年龄小于 12 个月、合并症的存在、治疗的医疗部门以及感染的第一波。
基于国家数据库的数据，我们表明，SARS-CoV-2 导致的儿科死亡率与其他国家相似。获得医疗服务和死亡率的分布存在异质性。弱势群体是年龄小于 12 个月的患者和有合并症的患者。
