Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care

doi:10.1093/cid/ciae133

. 2024 Aug 16;79(2):395-404.

doi: 10.1093/cid/ciae133.

Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care

Courtney M Rowan¹, Brenna LaBere^{2

3}, Cameron C Young⁴, Laura D Zambrano⁵, Margaret M Newhams⁴, Suden Kucukak⁴, Elizabeth R McNamara⁴, Elizabeth H Mack⁶, Julie C Fitzgerald⁷, Katherine Irby⁸, Aline B Maddux⁹, Jennifer E Schuster¹⁰, Michele Kong¹¹, Heda Dapul¹², Stephanie P Schwartz¹³, Melania M Bembea¹⁴, Laura L Loftis¹⁵, Amanda R Kolmar¹⁶, Christopher J Babbitt¹⁷, Ryan A Nofziger¹⁸, Mark W Hall¹⁹, Shira J Gertz²⁰, Natalie Z Cvijanovich²¹, Matt S Zinter²², Natasha B Halasa²³, Tamara T Bradford²⁴, Gwenn E McLaughlin²⁵, Aalok R Singh²⁶, Charlotte V Hobbs²⁷, Kari Wellnitz²⁸, Mary A Staat²⁹, Bria M Coates³⁰, Hillary R Crandall³¹, Mia Maamari³², Kevin M Havlin³³, Adam J Schwarz³⁴, Christopher L Carroll³⁵, Emily R Levy³⁶, Kristin L Moffitt³⁷, Angela P Campbell⁵, Adrienne G Randolph^{4

38}, Janet Chou²; Overcoming COVID-19 Investigators

Collaborators, Affiliations

Collaborators

Overcoming COVID-19 Investigators:
Michele Kong, Mary Glas Gaspers, Katri V Typpo, Ronald C Sanders, Katherine Irby, Adam J Schwarz, Christopher J Babbitt, Pia S Pannaraj, Helen Harvey, Natalie Z Cvijanovich, Matt S Zinter, Aline B Maddux, Emily Port, Sara Shankman, Rachel Mansour, Christopher L Carroll, John S Giuliano, Gwenn E McLaughlin, Paula S Espinal, Keiko M Tarquinio, Kelly N Michelson, Bria M Coates, Courtney M Rowan, Kari Wellnitz, Guru Bhoojhawon, Janice E Sullivan, Vicki L Montgomery, Kevin M Havlin, Tamara T Bradford, Melania M Bembea, Ana Lia Graciano, Adrienne G Randolph, Margaret M Newhams, Sabrina R Chen, Cameron C Young, Suden Kucukak, Mary Beth F Son, Janet S Chou, Brenna LaBere, Ryan W Carroll, Phoebe H Yager, Neil D Fernandes, Heidi R Flori, Janet R Hume, Emily R Levy, Brandi A Johnson, Noelle M Drapeau, Supriya Behl, Charlotte V Hobbs, Lacy Malloch, Lora Martin, Sarah McGraw, Jennifer E Schuster, Philip C Spinella, Amanda R Kolmar, Melissa L Cullimore, Russell J McCulloh, Katharine N Clouser, Shira J Gertz, Lawrence C Kleinman, Simon Li, Steven M Horwitz, Joseph Kuebler, Aalok R Singh, Adam J Ratner, Heda Dapul, Vijaya L Soma, Katherine V Biagas, Sule Doymaz, Stephanie P Schwartz, Tracie C Walker, Steven L Shein, Amanda N Lansell, Mark W Hall, Ryan A Nofziger, Mary Allen Staat, Julie C Fitzgerald, Ryan H Burnett, Jenny L Bush, Neal J Thomas, Ericka L Fink, Joseph A Carcillo, Andrew Butler, Elizabeth H Mack, Nelson Reed, Natasha B Halasa, Laura Stewart, Meena Golchha, Laura L Loftis, Marian Samperio, Alvaro Coronado Munoz, Jacob Qurashi, Cindy Bowens, Mia Maamari, Hillary Crandall, Lincoln S Smith, John K McGuire

Affiliations

¹ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA.
² Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
³ Division of Pulmonology, Section of Allergy-Immunology, Phoenix Children's Hospital, Phoenix, Arizona, USA.
⁴ Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
⁵ Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁶ Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
⁷ Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
⁸ Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
⁹ Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
¹⁰ Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.
¹¹ Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
¹² Division of Pediatric Critical Care Medicine, Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, New York, USA.
¹³ Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina, USA.
¹⁴ Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹⁵ Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
¹⁶ Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, USA.
¹⁷ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Miller Children's and Women's Hospital of Long Beach, Long Beach, California, USA.
¹⁸ Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio, USA.
¹⁹ Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
²⁰ Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA.
²¹ Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, Oakland, California, USA.
²² Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, California, USA.
²³ Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
²⁴ Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana, USA.
²⁵ Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.
²⁶ Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
²⁷ Department of Pediatrics, Division of Infectious Diseases, Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
²⁸ Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
²⁹ Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
³⁰ Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
³¹ Division of Pediatric Critical Care, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA.
³² Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas, Texas, USA.
³³ Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Louisville, and Norton Children's Hospital, Louisville, Kentucky, USA.
³⁴ Division of Critical Care Medicine, Children's Health Orange County (CHOC), Orange, California, USA.
³⁵ Division of Critical Care, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
³⁶ Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³⁷ Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
³⁸ Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.

PMID: 38465976
PMCID: PMC11327788
DOI: 10.1093/cid/ciae133

Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care

Courtney M Rowan et al. Clin Infect Dis. 2024.

. 2024 Aug 16;79(2):395-404.

doi: 10.1093/cid/ciae133.

Authors

Collaborators

Overcoming COVID-19 Investigators:
Michele Kong, Mary Glas Gaspers, Katri V Typpo, Ronald C Sanders, Katherine Irby, Adam J Schwarz, Christopher J Babbitt, Pia S Pannaraj, Helen Harvey, Natalie Z Cvijanovich, Matt S Zinter, Aline B Maddux, Emily Port, Sara Shankman, Rachel Mansour, Christopher L Carroll, John S Giuliano, Gwenn E McLaughlin, Paula S Espinal, Keiko M Tarquinio, Kelly N Michelson, Bria M Coates, Courtney M Rowan, Kari Wellnitz, Guru Bhoojhawon, Janice E Sullivan, Vicki L Montgomery, Kevin M Havlin, Tamara T Bradford, Melania M Bembea, Ana Lia Graciano, Adrienne G Randolph, Margaret M Newhams, Sabrina R Chen, Cameron C Young, Suden Kucukak, Mary Beth F Son, Janet S Chou, Brenna LaBere, Ryan W Carroll, Phoebe H Yager, Neil D Fernandes, Heidi R Flori, Janet R Hume, Emily R Levy, Brandi A Johnson, Noelle M Drapeau, Supriya Behl, Charlotte V Hobbs, Lacy Malloch, Lora Martin, Sarah McGraw, Jennifer E Schuster, Philip C Spinella, Amanda R Kolmar, Melissa L Cullimore, Russell J McCulloh, Katharine N Clouser, Shira J Gertz, Lawrence C Kleinman, Simon Li, Steven M Horwitz, Joseph Kuebler, Aalok R Singh, Adam J Ratner, Heda Dapul, Vijaya L Soma, Katherine V Biagas, Sule Doymaz, Stephanie P Schwartz, Tracie C Walker, Steven L Shein, Amanda N Lansell, Mark W Hall, Ryan A Nofziger, Mary Allen Staat, Julie C Fitzgerald, Ryan H Burnett, Jenny L Bush, Neal J Thomas, Ericka L Fink, Joseph A Carcillo, Andrew Butler, Elizabeth H Mack, Nelson Reed, Natasha B Halasa, Laura Stewart, Meena Golchha, Laura L Loftis, Marian Samperio, Alvaro Coronado Munoz, Jacob Qurashi, Cindy Bowens, Mia Maamari, Hillary Crandall, Lincoln S Smith, John K McGuire

Affiliations

¹ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA.
² Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
³ Division of Pulmonology, Section of Allergy-Immunology, Phoenix Children's Hospital, Phoenix, Arizona, USA.
⁴ Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
⁵ Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁶ Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
⁷ Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
⁸ Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
⁹ Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
¹⁰ Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.
¹¹ Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
¹² Division of Pediatric Critical Care Medicine, Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, New York, USA.
¹³ Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina, USA.
¹⁴ Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹⁵ Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
¹⁶ Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, USA.
¹⁷ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Miller Children's and Women's Hospital of Long Beach, Long Beach, California, USA.
¹⁸ Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio, USA.
¹⁹ Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
²⁰ Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA.
²¹ Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, Oakland, California, USA.
²² Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, California, USA.
²³ Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
²⁴ Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana, USA.
²⁵ Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.
²⁶ Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
²⁷ Department of Pediatrics, Division of Infectious Diseases, Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
²⁸ Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
²⁹ Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
³⁰ Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
³¹ Division of Pediatric Critical Care, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA.
³² Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas, Texas, USA.
³³ Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Louisville, and Norton Children's Hospital, Louisville, Kentucky, USA.
³⁴ Division of Critical Care Medicine, Children's Health Orange County (CHOC), Orange, California, USA.
³⁵ Division of Critical Care, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
³⁶ Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³⁷ Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
³⁸ Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.

PMID: 38465976
PMCID: PMC11327788
DOI: 10.1093/cid/ciae133

Abstract

Background: We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care.

Methods: Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted 12 March 2020-30 December 2021 to the pediatric intensive care unit (PICU) or high-acuity unit for acute COVID-19 were included.

Results: Of 1274 patients, 105 (8.2%) had an ICC, including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid-organ transplantation, 16 (15.2%) solid tumors, and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs 4.6%, P = .005) and hospitalization was longer (P = .01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, P = .40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19.

Conclusions: In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities.

Keywords: COVID-19; bacterial coinfection; critical care; immunocompromised host; pediatrics.

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Conflict of interest statement

Potential conflicts of interest. B. M. C. reports grants from NHLBI, American Lung Association, Doris Duke Foundation/Walder Foundation, and American Thoracic Society; payment for expert testimony from Tripplett Woolf Garretson; and participation on a multidisciplinary team for Sobi. N. B. H. reports grants from Sanofi, Quidel, and Merck. C. V. H. reports royalties, consulting fees, for Reviewer for Up To Date and Dynamed clinical databases; payment for presentations from Biofire; and expert consultation for the AstraZeneca FluMist Board. A. G. R. reports licenses as a Section Editor for Pediatric Critical Care Medicine, UpToDate, Inc; consulting fees from ThermoFisher, Inotrem; honoraria from a Grand Rounds presentation at St. Jude; support for meetings and/or travel from International Sepsis Forum, Institut Merieux, ThermoFisher; participation on an advisory board for the NIH Grace Study, REMAP-CAP, NIH-PREVENT-VILI; a medical advisory board member for Families Fighting Flu; chair member for International Sepsis Forum; and received reagents from Illumina, Inc. M. K. reports support for meetings and/or travel from the National Institute of Health (NIH) and a role on an advisory board for KultureCity. H. D. reports honoraria from Delex Pharma International, Inc. N. Z. C. reports grants from Cincinnati Children's Hospital Medical Center. J. C. F. reports grants from the National Institute of Diabetes and Digestive and Kidney Diseases (K23DK119463 and P50DK114786), and Pennsylvania CURE Grant. M. W. H. reports licenses from Kiadis, sub-board service for the American Board of Pediatrics, participation on a Data and Safety Monitoring Board (DSMB) for Abbvie, and receipt of drugs from Partner Therapeutics and Sobi. J. C. reports receipt of equipment from Illumina. B. L. reports receipt of an Immune Deficiency Foundation Research Grant. G. E. M. reports payment for expert testimony from Orlando Health, Bush Ross, Hall, Schiefflin & Smith, PA, Poole Brooks and Plumlee, PA, Hilltop Specialty Insurance, Smith, Hulsey, and Busey, PA. J. E. S. reports grants from the Food and Drug Administration (FDA), consulting fees from the Association for Professionals in Infection Control and Epidemiology (APIC), payment for presentations from the American Academy of Pediatrics, and participation on an advisory board for the American Association of Medical Colleges. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

**Figure 1.**
The distribution of specific type of ICCs. Mortality rates are described within each subcategory, along with the rates of HSCT. Abbreviations: CAR T, chimeric antigen receptor T-cell therapy; CNS, central nervous system; HSCT, hematopoietic stem cell transplantation; ICC, immunocompromising condition.

**Figure 2.**
Organ involvement and support in children and adolescents admitted to the pediatric intensive care unit with acute COVID-19 stratified by those with and without an ICC. A, Details of outcomes and organ support. B, Distribution of organ involvement in pediatric acute COVID-19 comparing those with immunocompromising conditions, displayed with black bars, to those without ICC, displayed in gray bars. Denominators for ejection fraction and pericarditis or pericardial effusion are the number of patients undergoing echocardiography (n = 41 for ICCs and n = 417 for no ICCs, respectively). Abbreviations: COVID-19, coronavirus disease 2019; CXR, chest radiograph; ECMO, extracorporeal membrane oxygenation; ICC, immunocompromising condition; LVEF, left ventricular ejection fraction; PARDS, pediatric acute respiratory distress syndrome.

See this image and copyright information in PMC

References

1. Tsankov BK, Allaire JM, Irvine MA, et al. Severe COVID-19 infection and pediatric comorbidities: a systematic review and meta-analysis. Int J Infect Dis 2021; 103:246–56. - PMC - PubMed
1. Minotti C, Tirelli F, Barbieri E, Giaquinto C, Dona D. How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review. J Infect 2020; 81:e61–6. - PMC - PubMed
1. Cazzaniga M, Testa S, Brambilla M, Vergori A, Viganoni M, Montini G. Incidence and outcome of SARS-CoV-2 infection in a pediatric kidney transplant recipient cohort from a single center in Northern Italy. Pediatr Transplant 2022; 26:e14335. - PMC - PubMed
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[1] Tsankov BK, Allaire JM, Irvine MA, et al. Severe COVID-19 infection and pediatric comorbidities: a systematic review and meta-analysis. Int J Infect Dis 2021; 103:246–56. - PMC - PubMed

[2] Tsankov BK, Allaire JM, Irvine MA, et al. Severe COVID-19 infection and pediatric comorbidities: a systematic review and meta-analysis. Int J Infect Dis 2021; 103:246–56. - PMC - PubMed

[3] Minotti C, Tirelli F, Barbieri E, Giaquinto C, Dona D. How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review. J Infect 2020; 81:e61–6. - PMC - PubMed

[4] Minotti C, Tirelli F, Barbieri E, Giaquinto C, Dona D. How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review. J Infect 2020; 81:e61–6. - PMC - PubMed

[5] Cazzaniga M, Testa S, Brambilla M, Vergori A, Viganoni M, Montini G. Incidence and outcome of SARS-CoV-2 infection in a pediatric kidney transplant recipient cohort from a single center in Northern Italy. Pediatr Transplant 2022; 26:e14335. - PMC - PubMed

[6] Cazzaniga M, Testa S, Brambilla M, Vergori A, Viganoni M, Montini G. Incidence and outcome of SARS-CoV-2 infection in a pediatric kidney transplant recipient cohort from a single center in Northern Italy. Pediatr Transplant 2022; 26:e14335. - PMC - PubMed

[7] Chappell H, Patel R, Driessens C, et al. Immunocompromised children and young people are at no increased risk of severe COVID-19. J Infect 2022; 84:31–9. - PMC - PubMed

[8] Chappell H, Patel R, Driessens C, et al. Immunocompromised children and young people are at no increased risk of severe COVID-19. J Infect 2022; 84:31–9. - PMC - PubMed

[9] Graff K, Smith C, Silveira L, et al. Risk factors for severe COVID-19 in children. Pediatr Infect Dis J 2021; 40:e137–45. - PubMed

[10] Graff K, Smith C, Silveira L, et al. Risk factors for severe COVID-19 in children. Pediatr Infect Dis J 2021; 40:e137–45. - PubMed

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Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care

Collaborators

Affiliations

Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

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