Citations 2
Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care
Rowan, Courtney M. , Zambrano, Laura D. , Newhams, Margaret M. , Kücükak, Suden, McNamara, Elizabeth R, Mack, Elizabeth H. , Fitzgerald, Julie C. , Irby, Katherine , Schuster, Jennifer E. , Kong, Michele, Loftis, Laura L. , Kolmar, Amanda , Babbitt, Christopher , Nofziger, Ryan A. , Hall, Mark W. , Gertz, Shira J. , Zinter, Matt S. , Halasa, Natasha , Bradford, Tamara T. , McLaughlin, Gwenn E., Singh, Aalok R. , Staat, Mary Allen , Coates, Bria M. , Crandall, Hillary R, Maamari, Mia , Havlin, Kevin , Schwarz, Adam J. , Carroll, Christopher L. , Levy, Emily R. , Campbell, Angela P. , Randolph, Adrienne G. , Chou, Janet , Investigators, Overcoming COVID-19, Kong, Michele, Gaspers, Mary Glas , Sanders, Ronald C., Schwarz, Adam J, Harvey, Helen , Port, Emily, Shankman, Sara, Mansour, Rachel, Espinal, Paula S., Tarquinio, Keiko M. , Bhoojhawon, Guru , Sullivan, Janice E, Bradford, Tamara T, Newhams, Margaret M, Chen, Sabrina , Young, Cameron C, Carroll, Ryan W. , Yager, Phoebe H. , Flori, Heidi R. , Johnson, Brandi A., Drapeau, Noelle M., Malloch, Lacy , Martin, Lora, McGraw, Sarah , Schuster, Jennifer E, Cullimore, Melissa L. , Clouser, Katharine N. , Kleinman, Lawrence C. , Horwitz, Steven M. , Kuebler, Joseph D. , Soma, Vijaya L, Doymaz, Sule , Schwartz, Stephanie P, Walker, Tracie C. , Lansell, Amanda , Hall, Mark W. , Burnett, Ryan H., Bush, Jenny L., Carcillo, Joseph A. , Butler, Andrew , Reed, Nelson, Stewart, Laura S , Golchha, Meena, Samperio, Marian, Qurashi, Jacob , Bowens, Cindy , Crandall, Hillary , Smith, Lincoln , Kong, Michele , Martin, Lora , Randolph, Adrienne G , Levy, Emily R , Kong, Michele , Staat, Mary A , Gertz, Shira J , LaBere, Brenna , Young, Cameron C. , Maddux, Aline B. , Kong, Michele, Dapul, Heda , Schwartz, Stephanie P. , Bembea, Melania M. , Cvijanovich, Natalie Z , Hobbs, Charlotte V. , Wellnitz, Kari , Moffitt, Kristin , Investigators, Overcoming COVID-19, Kong, Michele, Typpo, Katri , Schwarz, Adam J, Pannaraj, Pia S. , Giuliano, John S. , Michelson, Kelly Nicole , Sullivan, Janice E, Montgomery, Vicki , Bradford, Tamara T, Graciano, Ana Lía , Newhams, Margaret M, Young, Cameron C, Son, Mary Beth F. , Fernandes, Neil D. , Hume, Janet R. , Behl, Supriya , McGraw, Sarah, Schuster, Jennifer E, Spinella, Philip C. , McCulloh, Russell J. , Li, Simon , Ratner, Adam J. , BIAGAS, KATHERINE V. , Schwartz, Stephanie P, Shein, Steven L. , Bush, Jenny, Thomas, Neal J. , Fink, Ericka L. , Reed, Nelson, Muñoz, Álvaro Coronado , McGuire, John K.
Clinical Infectious Diseases | March 11, 2024 | Volume: 79 | Issue: 2 | Pages: 395-404
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.
A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020
Schuster, Jennifer E. , Halasa, Natasha , Nakamura, Mari , Levy, Emily R. , Young, Cameron C. , Newhams, Margaret M. , Bourgeois, Florence T. , Staat, Mary Allen , Hobbs, Charlotte V. , Feldstein, Leora R. , Jackson, A. , Mack, Elizabeth H. , Walker, Tracie C. , Spinella, Philip C. , Loftis, Laura L. , Kong, Michele , Rowan, Courtney M. , McLaughlin, Gwenn E., Hall, Mark W. , Babbitt, Christopher , Maamari, Mia , Zinter, Matt S. , Gertz, Shira J. , Carroll, Christopher L. , Singh, Aalok R. , Hymes, Saul , Schwarz, Adam J. , McGuire, John K. , Nofziger, Ryan A. , Flori, Heidi R. , Clouser, Katharine N. , Wellnitz, Kari , Cullimore, Melissa L. , Hume, Janet R. , Patel, Manish , Randolph, Adrienne G. , Investigators, Overcoming COVID-19, Patel, Manish R. , Feldstein, Leora R , Levy, Emily R , Young, Cameron C , Randolph, Adrienne G , Spinella, Philip C , Kong, Michele , Hume, Janet R , Hobbs, Charlotte V , Staat, Mary A , Gertz, Shira J , Hymes, Saul R , Fitzgerald, Julie C. , Dapul, Heda , Jackson, Ashley M, Maddux, Aline B. , Bembea, Melania M. , Cvijanovich, Natalie Z , Michelson, Kelly Nicole , Thomas, Neal J. , Giuliano, John S. , Investigators, Overcoming COVID-19
Journal of the Pediatric Infectious Diseases Society | November 17, 2021 | Volume: 11 | Issue: 5 | Pages: 191-198
Abstract Background It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered. Methods Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated. Results Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI: 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI: 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December). Conclusion Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies.