Universidade Federal de Viçosa, Programa de Pós-Graduação em Ciências da Saúde, Viçosa, Minas Gerais, Brazil.
Universidade Federal de Viçosa, Departamento de Medicina e Enfermagem, Viçosa, Minas Gerais, Brazil.
Rev Inst Med Trop Sao Paulo. 2023 Jan 30;65:e11. doi: 10.1590/S1678-9946202365011. eCollection 2023.
This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of children and adolescents with severe acute respiratory infection (SARI) caused by SARS-CoV-2 nationwide. The study comprised 6,843 children and adolescents hospitalized in 2020 who tested positive for COVID-19, based on data from the Influenza Epidemiological Surveillance Information System. Sociodemographic and clinical profiles, hospitalization frequency, lethality and recovery rates were analyzed. The outcome was recovery or death. The 6,843 children and adolescents comprised 1.9% of SARI hospitalized cases (n = 563,051). Of these, 57.7% developed critical SARI and 90% survived. Comorbidities were present in 40.8%, especially asthma, immunodepression, and neurological and cardiovascular diseases. The main symptoms were fever, cough, dyspnea, respiratory distress, and low oxygen saturation. Among those with critical SARI, 91.4% died. There was a higher frequency of children, especially those under five years of age and of mixed ethnicity. The highest hospitalization frequency occurred in the Southeastern and Northeastern regions, the highest recovery rates in the Southeastern and Southern regions, and the highest lethality rates in the Northern and Northeastern regions. Deaths were associated with ages ranging from 12 to 19 and being under one year of age, living in the Northern and Northeastern regions, progression to critical SARI, and having immunosuppression and cardiovascular disease. In contrast, asthma was associated with lower death rates. The frequency of complications and mortality rates caused by SARS-Cov-2 in the pediatric population are relevant, as well as the severity of the epidemic in the social inequality context and the health services' frailty.
本研究旨在分析全国因严重急性呼吸道感染（SARI）由 SARS-CoV-2 导致住院的儿童和青少年的住院情况及相关死亡因素。该研究纳入了 2020 年因 COVID-19 检测呈阳性而住院的 6843 名儿童和青少年，数据来自流感流行病学监测信息系统。分析了人口统计学和临床特征、住院频率、病死率和恢复率。结局为恢复或死亡。6843 名儿童和青少年占 SARI 住院病例的 1.9%（n=563051）。其中，57.7%发生重症 SARI，90%存活。40.8%合并有合并症，特别是哮喘、免疫抑制以及神经和心血管疾病。主要症状为发热、咳嗽、呼吸困难、呼吸窘迫和低血氧饱和度。在重症 SARI 患者中，91.4%死亡。儿童居多，特别是 5 岁以下和混合种族儿童。住院频率最高的是东南部和东北部地区，恢复率最高的是东南部和南部地区，病死率最高的是北部和东北部地区。死亡与 12 至 19 岁和 1 岁以下、居住在北部和东北部地区、进展为重症 SARI、免疫抑制和心血管疾病相关。相反，哮喘与较低的死亡率相关。SARS-CoV-2 在儿科人群中引起的并发症和死亡率的频率以及在社会不平等背景下的疾病严重程度和卫生服务的脆弱性值得关注。
