Costa Vânia Chagas da, Montarroyos Ulisses Ramos, Lopes Katiuscia Araújo de Miranda, Santos Ana Célia Oliveira Dos
Postgraduate Program in Health Sciences, Universidade de Pernambuco, Recife 50100-130, Brazil.
School of Nursing Our Lady of Grace, Universidade de Pernambuco, Recife 50100-130, Brazil.
Epidemiologia (Basel). 2025 Aug 4;6(3):40. doi: 10.3390/epidemiologia6030040.
BACKGROUND/OBJECTIVE: The COVID-19 pandemic profoundly transformed social life worldwide, indiscriminately affecting individuals across all age groups. Children have not been exempted from the risk of severe illness and death caused by COVID-19.
This paper sought to describe the clinical findings, laboratory and imaging results, and hospital care provided for severe and critical cases of COVID-19 in unvaccinated children, with or without severe asthma, hospitalized in a public referral service for COVID-19 treatment in the Brazilian state of Pernambuco.
This was a case series study of severe and critical COVID-19 in hospitalized, unvaccinated children, with or without severe asthma, conducted in a public referral hospital between March 2020 and June 2021.
The case series included 80 children, aged from 1 month to 11 years, with the highest frequency among those under 2 years old (58.8%) and a predominance of males (65%). Respiratory diseases, including severe asthma, were present in 73.8% of the cases. Pediatric multisystem inflammatory syndrome occurred in 15% of the children, some of whom presented with cardiac involvement. Oxygen therapy was required in 65% of the cases, mechanical ventilation in 15%, and 33.7% of the children required intensive care in a pediatric intensive care unit. Pulmonary infiltrates and ground-glass opacities were common findings on chest X-rays and CT scans; inflammatory markers were elevated, and the most commonly used medications were antibiotics, bronchodilators, and corticosteroids.
This case series has identified key characteristics of children with severe and critical COVID-19 during a period when vaccines were not yet available in Brazil for the study age group. However, the persistence of low vaccination coverage, largely due to parental vaccine hesitancy, continues to leave children vulnerable to potentially severe illness from COVID-19. These findings may inform the development of public health emergency contingency plans, as well as clinical protocols and care pathways, which can guide decision-making in pediatric care and ensure appropriate clinical management, ultimately improving the quality of care provided.
背景/目的：新冠疫情深刻改变了全球社会生活，毫无差别地影响着所有年龄段的人群。儿童也未能免于新冠病毒所致重症和死亡风险。
本文旨在描述在巴西伯南布哥州一家新冠治疗公共转诊机构住院治疗的未接种疫苗儿童（无论有无重度哮喘）中，新冠重症和危重症病例的临床症状、实验室及影像学检查结果，以及所接受的医院护理情况。
这是一项针对2020年3月至2021年6月期间在一家公共转诊医院住院治疗的未接种疫苗儿童（无论有无重度哮喘）中的新冠重症和危重症病例的病例系列研究。
该病例系列纳入了80名年龄从1个月至11岁的儿童，其中2岁以下儿童占比最高（58.8%），男性居多（65%）。73.8%的病例患有呼吸系统疾病，包括重度哮喘。15%的儿童发生了儿童多系统炎症综合征，其中一些儿童出现了心脏受累情况。65%的病例需要吸氧治疗，15%需要机械通气，33.7%的儿童需要在儿科重症监护病房接受重症护理。胸部X光和CT扫描常见的表现为肺部浸润和磨玻璃影；炎症标志物升高，最常用的药物是抗生素、支气管扩张剂和皮质类固醇。
该病例系列确定了在巴西研究年龄组尚无疫苗可用期间，新冠重症和危重症儿童的关键特征。然而，由于家长对疫苗犹豫不决，疫苗接种率持续较低，儿童仍然容易因新冠病毒感染而罹患潜在重症。这些发现可为制定突发公共卫生事件应急预案以及临床诊疗方案和护理路径提供参考，从而指导儿科护理决策并确保适当的临床管理，最终提高护理质量。
