Clinical Studies, Trials and Projection Unit, Indian Council of Medical Research, New Delhi, India.
Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Pediatr. 2023 Oct;90(10):1000-1007. doi: 10.1007/s12098-022-04449-w. Epub 2023 Feb 16.
To evaluate the factors associated with mortality of a multicentric cohort of hospitalized COVID-19 patients, 0-18 y old, from 42 centers across India.
The National Clinical Registry for COVID-19 (NCRC) is an on-going prospective data collection platform enrolling COVID-19 patients diagnosed by real-time PCR or rapid antigen test. The data are collected in prestructured e-capture forms. The sociodemographic, clinical, laboratory, and hospital outcome data from 1 September 2020 to 20 February 2022 were analyzed.
Of the 1244 enrolled hospitalized COVID-19 patients aged 0-18 y, 98 and 124 were infants and neonates, respectively. Only 68.6% children were symptomatic at admission, with fever being the most common symptom. Diarrhea, rash, and neurological symptoms were also noted. At least 1 comorbidity was present in 260 (21%) children. The in-hospital mortality rate was 6.2% (n = 67), the highest in infants (12.5%). Altered sensorium (aOR: 6.8, CI: 1.9, 24.6), WHO ordinal scale ≥ 4 at admission (aOR: 19.6, CI: 8.0, 47.8), and malignancy (aOR: 8.9, 95% CI: 2.4, 32.3) were associated with higher odds of death. Malnutrition did not affect the outcome. Mortality rates were similar across the three waves of the pandemic, though a significant shift towards the under-five group was observed in the third wave.
This multicentric cohort of admitted Indian children showed that the COVID-19 was milder in children than adults, and the pattern was consistent across all waves of the pandemic.
评估来自印度 42 个中心的多中心队列中住院 COVID-19 患儿（0-18 岁）的死亡率相关因素。
国家 COVID-19 临床登记处（NCRC）是一个正在进行的前瞻性数据收集平台，招募通过实时 PCR 或快速抗原检测诊断的 COVID-19 患者。数据以预结构化电子捕获形式收集。对 2020 年 9 月 1 日至 2022 年 2 月 20 日期间的社会人口统计学、临床、实验室和医院结局数据进行了分析。
在纳入的 1244 名住院 COVID-19 患儿（0-18 岁）中，98 名和 124 名分别为婴儿和新生儿。仅 68.6%的患儿在入院时出现症状，最常见的症状是发热。还注意到腹泻、皮疹和神经症状。260 名（21%）患儿至少存在 1 种合并症。住院死亡率为 6.2%（n=67），婴儿最高（12.5%）。意识改变（OR：6.8，95%CI：1.9，24.6）、入院时 WHO 等级量表≥4（OR：19.6，95%CI：8.0，47.8）和恶性肿瘤（OR：8.9，95%CI：2.4，32.3）与更高的死亡风险相关。营养不良对结局无影响。尽管在第三波疫情中观察到明显向五岁以下组转移的趋势，但各波疫情的死亡率相似。
该纳入印度患儿的多中心队列表明，COVID-19 在儿童中的严重程度低于成人，且在各波疫情中模式一致。
