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. 2023 Apr 14:36:100763.
doi: 10.1016/j.lanwpc.2023.100763. Online ahead of print.

COVID-19 related ICU admissions in paediatric and young adult patients in Australia: a national case series 2020-2022

Madeleine Otto  1 , Philip N Britton  2 , Ary Serpa Neto  3 , Simon Erickson  4 , Marino Festa  5 , Nigel W Crawford  6   7 , Aidan J C Burrell  1   3 , Andrew A Udy  1   3 ; SPRINT-SARI Australia Investigators
Affiliations

COVID-19 related ICU admissions in paediatric and young adult patients in Australia: a national case series 2020-2022

Madeleine Otto et al. Lancet Reg Health West Pac. .

Abstract

Background: COVID-19 pandemic research efforts have focused on disease phenotypes in adults. A distinct spectrum of illness has been documented in paediatric populations. We aimed to review paediatric intensive care unit (ICU) admissions in Australia, across differing variant predominant phases of the pandemic.

Methods: Data reported to the Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection (SPRINT-SARI) Australia, across 49 ICUs from February 2020 to June 2022 were extracted. We defined 'child' as patients aged <12 years, 'adolescent' as patients aged 12-17 years, and 'young adult' as patients aged 18-25 years.

Findings: We identified 226 paediatric ICU admissions with COVID-19, representing 3.9% of ICU admissions across the study period. Comorbidity was present in 34.6% of children, 51.4% of adolescents, and 48.7% of young adults. The need for respiratory support was highest in young adults. While 28.3% of patients <18 years required invasive ventilation, in-hospital mortality in paediatric patients was 3.6%. During the Omicron period, there was an increase in the annualised incidence of age-specific COVID-19 ICU admissions per 100,000 population, albeit a decrease in the incidence per 1000 SARS-CoV-2 notifications.

Interpretation: This study demonstrated an appreciable burden of COVID-19 in paediatric patients. Adolescent patients presented phenotypically similar to young adults, however, illness severity was lower in younger cohorts. The Omicron phase of the pandemic demonstrated an increased age-specific population incidence of COVID-19 ICU admissions, albeit a reduced incidence when based on SARS-CoV-2 notifications.

Funding: SPRINT-SARI Australia is supported by the Department of Health, Commonwealth of Australia [Standing Deed SON60002733].

Keywords: Adolescent; COVID-19; Child; Infant; Intensive care; SARS-CoV-2.

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Conflict of interest statement

Professor Andrew A Udy has the following disclosures: funding for SPRINT-SARI (Department of Health, Commonwealth of Australia [Standing Deed SON60002733]) is provided to 10.13039/501100001779Monash University as the administering institution; recipient of Grant funding (paid to 10.13039/501100001779Monash University) from the 10.13039/501100000925National Health and Medical Research Council (NHMRC) Australia, for research projects outside of the current work; recipient of Grant funding (paid to 10.13039/501100001779Monash University) from the Medical Research Future Fund (MRFF) Australia, for research projects outside of the current work; recipient of financial support from Integra Lifesciences for the delivery of a presentation at the Neurosurgical Society of Australasia Conference 2022; recipient of in-kind support (trial consumables) from Integra Lifesciences, for research projects outside of the current work. Associate Professor Philip N Britton has the following disclosures: recipient of the NHMRC Early Career Fellowship – APP1145817; recipient of the Royal Australian College of Physicians Foundation Cottrell Research Establishment Fellowship 2022. Associate Professor Nigel W Crawford has the following disclosure: member and current Chair of the National Vaccine Advisory Committee (ATAGI). There are no further conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Cumulative number of paediatric∗ patients admitted to the intensive care unit throughout the study period stratified by age group. Abbreviations: ICU: intensive care unit. ∗ Paediatric is < 18 years.
Fig. 2
Fig. 2
Distribution of paediatric∗ intensive care unit admissions by year of age. ∗ Paediatric is < 18 years.
Fig. 3
Fig. 3
Proportion of comorbidities in paediatric∗ patients, stratified by patients <12 years of age (Child), and patients aged 12–17 years (Adolescent). ∗ Paediatric is < 18 years.
See this image and copyright information in PMC

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