Wu Jeng-Hung, Wang Ching-Chia, Lu Frank Leigh, Huang Shu-Chien, Yen Ting-Yu, Lu Chun-Yi, Chang Luan-Yin, Wu En-Ting
Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Medicine, National Taiwan University Hospital, Jinshan Branch, New Taipei City, Taiwan.
Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2025 Feb;124(2):133-138. doi: 10.1016/j.jfma.2024.07.025. Epub 2024 Aug 7.
Since April 2022, the SARS-CoV-2 Omicron variant has caused a notable increase in pediatric COVID-19 cases in Taiwan. During the acute phase of infection, some children required admissions to pediatric intensive care units (PICU). This study aimed to analyze their clinical presentations and outcomes while exploring associated factors.
Medical records were retrospectively collected from patients with COVID-19 (aged <18 years) admitted to our PICU from April 2022-March 2023. Early stage is defined as the period without adequate vaccination and treatment guidelines for children from April-June 2022, and the remaining months are referred to as late stage. Clinical characteristics and outcomes were compared between patients in early and late stages.
We enrolled 78 children with COVID-19, with a median length of stay (LOS) in PICU of 3 days and a 5% mortality rate. Patients admitted during the early stage had lower vaccination rates (7% vs. 50%), higher pediatric logistic organ dysfunction scores (2 vs. 0.1), and longer LOS in the PICU (6 vs. 2 days) than those admitted during the late stage. Multivariate analysis identified admission during the early stage as a risk factor for prolonged LOS (>7 days) in the PICU (odds ratio: 3.65, p = 0.047).
Without available vaccinations and suitable treatment guidelines, children with COVID-19 tended to have more severe illness and prolonged LOS in the PICU. These observations highlight the importance of vaccinations and familiarity of medical providers with adequate management of this newly-emerging infectious disease.
自2022年4月以来，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎变种导致台湾地区儿童新冠肺炎病例显著增加。在感染急性期，一些儿童需要入住儿科重症监护病房（PICU）。本研究旨在分析他们的临床表现和预后，同时探索相关因素。
回顾性收集2022年4月至2023年3月入住我院PICU的新冠肺炎患者（年龄<18岁）的病历。早期定义为2022年4月至6月期间，当时儿童尚无足够的疫苗接种和治疗指南，其余月份称为晚期。比较早期和晚期患者的临床特征和预后。
我们纳入了78例新冠肺炎儿童患者，在PICU的中位住院时间（LOS）为3天，死亡率为5%。与晚期入院的患者相比，早期入院的患者疫苗接种率较低（7%对50%），儿科逻辑器官功能障碍评分较高（2对0.1），在PICU的住院时间较长（6天对2天）。多变量分析确定早期入院是PICU中住院时间延长（>7天）的危险因素（优势比：3.65，p = 0.047）。
在没有可用疫苗接种和合适治疗指南的情况下，新冠肺炎儿童往往病情更严重，在PICU的住院时间更长。这些观察结果凸显了疫苗接种以及医疗服务提供者熟悉这种新出现传染病的适当管理的重要性。
