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Multicenter Study
. 2024 Mar 6;14(1):5539.
doi: 10.1038/s41598-024-55065-x.

Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting

Emmerson C F de Farias  1   2 , Manoel J C Pavão Junior  3 , Susan C D de Sales  3 , Luciana M P P do Nascimento  3 , Dalila C A Pavão  3 , Anna P S Pinheiro  3 , Andreza H O Pinheiro  3 , Marília C B Alves  3 , Kíssila M M M Ferraro  3 , Larisse F Q Aires  3 , Luana G Dias  3 , Mayara M M Machado  3 , Michaelle J D Serrão  3 , Raphaella R Gomes  3 , Sara M P de Moraes  3 , Gabriella M G Moura  3 , Adriana M B de Sousa  3 , Gabriela C L Pontes  3 , Railana D F P Carvalho  3 , Cristiane T C Silva  3 , Guilherme Lemes  3 , Bruna da C G Diniz  3 , Aurimery G Chermont  4 , Kellen F S de Almeida  4 , Salma B Saraty  5 , Mary L F Maia  5 , Miriam R C Lima  5 , Patricia B Carvalho  6 , Renata de B Braga  6 , Kathia de O Harada  6 , Maria C A Justino  7 , Gleice Clemente  8 , Maria Teresa Terreri  8 , Marta C Monteiro  9
Affiliations
Multicenter Study

Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting

Emmerson C F de Farias et al. Sci Rep. .

Abstract

SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo-18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2-28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3-202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4-13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization.

Keywords: Child health; Intensive Care Unit; Mortality; Pediatric; Risk factor; SARS-CoV-2 virus.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form. All the authors have non-financial nor conflict of interests to disclose.

Figures

Figure 1
Figure 1
Flowchart describing the study design and selection of participants. PICU, Pediatric Intensive care unit.
See this image and copyright information in PMC

References

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Supplementary concepts