Some Children With COVID-19 Require Admission, PICU Care
Elevated CRP, procalcitonin, pro-BNP, platelet count -- but not obesity, asthma -- linked to PICU admission
WEDNESDAY, May 20, 2020 (HealthDay News) -- Some children with COVID-19 require admission and intensive care, according to a study published online May 11 in The Journal of Pediatrics.
Jerry Y. Chao, M.D., from the Albert Einstein College of Medicine in Bronx, New York, and colleagues describe the clinical profile and risk factors for critical illness among 67 children aged 1 month to 21 years who tested positive for COVID-19 between March 15 and April 13, 2020.
Overall, 31.3 percent of the children were managed as outpatients. The researchers found that 72 percent of the 46 admitted patients were admitted to the general pediatric medical unit and 28 percent (13 children) were admitted to the pediatric intensive care unit (PICU). Obesity and asthma were highly prevalent but were not linked to admission to the PICU. Higher C-reactive protein, procalcitonin, and pro-B type natriuretic peptide levels and platelet counts were significantly associated with admission to the PICU. Seven PICU patients (53.8 percent) had severe sepsis and septic shock syndromes. Ten PICU patients (77 percent) had acute respiratory distress syndrome, and six of these patients required invasive mechanical ventilation (median, nine days). Eight of the 13 PICU patients were discharged home, while four remained hospitalized on ventilatory support at day 14 (61.5 and 30.7 percent, respectively); after withdrawal of life-sustaining therapy, one patient died because of metastatic cancer.
"This research is a sobering reminder that children are not immune to this virus and some do require a higher level of care," a coauthor said in a statement.