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. 2022 Apr 14:10:868297.
doi: 10.3389/fped.2022.868297. eCollection 2022.

Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America

Eduardo López-Medina  1   2   3 , German Camacho-Moreno  4 , Martin E Brizuela  5 , Diana M Dávalos  1   6 , Juan Pablo Torres  7 , Rolando Ulloa-Gutierrez  8 , Pio López  1   2 , Roberto Debbag  9 , Paola Pérez  6   10 , Jaime Patiño  6   10 , Ximena Norero  11 , Cristina Mariño  12 , Miguel A Luengas  12 , Gabriela Ensinck  13 , Carlos Daza  14 , Kathia Luciani  15 , Paola Quintana Kuhner  16 , Mónica Rodriguez  16 , Juan Pablo Rodríguez-Auad  17 , Alejandra Estrada-Villarroel  17 , Mayli Carnevale  18 , Orlando Cesar Mantese  19 , Eitan N Berezin  20 , José Iván Castillo  21 , Abiel Mascareñas  22 , Andrea Jimenez-Zambrano  23 , Lourdes Dueñas  24 , Mario Melgar  25 , Nancy Galvez  25 , Erika Cantor  1   26 , Edwin J Asturias  23   27
Affiliations

Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America

Eduardo López-Medina et al. Front Pediatr. .

Abstract

Background: Limited data is available from low-middle and upper-middle income countries of the factors associated with hospitalization or admission to pediatric intensive care unit (PICU) for children with COVID-19.

Objective: To describe the factors associated with hospitalization or PICU admission of children with COVID-19 in Latin America.

Method: Multicenter, analytical, retrospective study of children reported from 10 different Latin American countries to the Latin-American Society of Pediatric Infectious Diseases (SLIPE-COVID) research network from June 1, 2020, and February 28, 2021. Outpatient or hospitalized children <18 years of age with COVID-19 confirmed by polymerase chain reaction or antigen detection from the nasopharynx were included. Children with multisystem inflammatory syndrome in children (MIS-C) were excluded. Associations were assessed using univariate and multivariable logistic regression models.

Results: A total of 1063 children with COVID-19 were included; 500 (47%) hospitalized, with 419 (84%) to the pediatric wards and 81 (16%) to the ICU. In multivariable analyses, age <1 year (Odds Ratio [OR] 1.78; 95% CI 1.08-2.94), native race (OR 5.40; 95% CI 2.13-13.69) and having a co-morbid condition (OR 5.3; 95% CI 3.10-9.15), were associated with hospitalization. Children with metabolic or endocrine disorders (OR 4.22; 95% CI 1.76-10.11), immune deficiency (1.91; 95% CI 1.05-3.49), preterm birth (OR 2.52; 95% CI 1.41-4.49), anemia at presentation (OR 2.34; 95% CI 1.28-4.27), radiological peribronchial wall thickening (OR 2.59; 95% CI 1.15-5.84) and hypoxia, altered mental status, seizures, or shock were more likely to require PICU admission. The presence of pharyngitis (OR 0.34; 95% CI 0.25-0.48); myalgia (OR 0.47; 95% CI 0.28-0.79) or diarrhea (OR 0.38; 95% CI 0.21-0.67) were inversely associated with hospital admission.

Conclusions: In this data analysis reported to the SLIPE research network in Latin America, infants, social inequalities, comorbidities, anemia, bronchial wall thickening and specific clinical findings on presentation were associated with higher rates of hospitalization or PICU admission. This evidence provides data for prioritization prevention and treatment strategies for children suffering from COVID-19.

Keywords: COVID-19; SARS-CoV-2; children; critical care; hospitalization.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
SLIPE-COVID research network-city locations and sites.
Figure 2
Figure 2
Risk factors among pediatric patients with COVID-19. Multiple imputation chained equations for missing data. (A) Hospital admission (general pediatric ward or pediatric intensive care unit). (B) Pediatric intensive care admission among hospitalized patients.
See this image and copyright information in PMC

References

    1. Pathak EB, Salemi JL, Sobers N, Menard J, Hambleton IR. COVID-19 in Children in the United States: Intensive Care Admissions, Estimated Total Infected, and Projected Numbers of Severe Pediatric Cases in 2020. J Public Health Manag Pract. (2020) 26:325–33. 10.1097/PHH.0000000000001190 - DOI - PMC - PubMed
    1. Mehta NS, Mytton OT, Mullins EWS, Fowler TA, Falconer CL, Murphy OB, et al. . SARS-CoV-2 (COVID-19): What Do We Know About Children? A Systematic Review. Clin Infect Dis. (2020) 71:2469–79. 10.1093/cid/ciaa556 - DOI - PMC - PubMed
    1. Panamerican Health Organization . PAHO. Geo-Hub COVID-19 - Information System for the Region of the Americas. (2022). Available online at: https://paho-covid19-response-who.hub.arcgis.com (accessed February 24, 2022).
    1. Gobierno de Chile. Plan de Acción Coronavirus (2022). Available online at: https://www.gob.cl/coronavirus/cifrasoficiales/#datos (accessed February 24, 2022).
    1. Dirección general de Epidemiología . Gobierno de Mexico. COVID-19 Mexico Tablero general CONACYT. Available online at: https://datos.covid-19.conacyt.mx (accessed February 24, 2022).