Citations 8
Association of Early Steroid Administration With Outcomes of Children Hospitalized for COVID-19 Without Multisystem Inflammatory Syndrome in Children
Nadiger, Meghana , McGarvey, Jeremy , Harthan, Aaron A. , Lombardo, Mónica, Perkins, Nicholas , Sayed, Imran A., Bhalala, Utpal , Raju, Umamaheswara, Miller, Aaron S., Boman, Karen , Arteaga, Grace M. , Bansal, Vikas , Tekin, Aysun , Kumar, Vishakha K. , Group, Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator, Kovačević, Tanja , Markić, Joško , Ardalic, Tatjana Capitovic , Polić, Branka , Ivić, Ivo, Carev, Dominko , Glavinić, Robert, Vadgaonkar, Girish, Ediga, Rekha, Basety, Shilpa, Dammareddy, Shwetha, Kasumalla, Phani Sreeharsha, Manduva, Janaki, Kolakani, Naresh, Sripathi, Shreeja , Chaitanya, Sheetal, Papani, Sridhar, Kamuram, Mahesh, Mohan, Surapaneni Krishna, Jyothisree, Ekambaram, Petrolwala, Mukur, Ladva, Bharat, Kodate, Akira, Suzuki, Reina , Moriki, Koyo, Hassan-Hanga, Fatimah , Gezawa, Abubakar Shehu, Kabara, Halima M. S., Amole, Taiwo Gboluwaga , Kabir, Halima , Haliru, Dalha Gwarzo, Ibrahim, Abdullahi S., Asghar, Muhammad Sohaib , Syed, Mashaal , Naqvi, Syed Anosh Ali, Yasmin, Farah , Ahmed, Iftekhar , Ishaque, Sidra , Saleem, Ali Faisal , Alarifi, Mohammed I, Macarambon, Jara Mia, Bukhari, Ahmad Abdullah, Albahrani, Hussain A., Aldossary, Kaltham M., Malki, Walid, Kouzoukas, Brenna, Jacobs, Nekaiya, Ganbote, Tejashree, Valentine, Beryl, Sreerama, Pavan, Havalad, Vinod, Barry, Suzanne, Woll, Christopher , Wu, Gregory F. , Carrole, Erin, Burke, Kathryn , Irby, Katherine , Sanders, Ronald C., Hefley, Glenda, Christie, Amy B. , Adiga, Rajani, Campbell, Beth Salvagio , Wilson, Cathleen, Rivers, Patrick , Brinks, Jonathan, Mongoh, Mokenge Ndiva, Gilson, Boris, Danesh, Valerie , Dubrocq, Gueorgui , Davis, Amber, Hammers, Marissa J, McGahey, Ill M, Farris, Amanda C., Priest, Elisa L. , Korsmo, Robyn, Fares, Lorie, Skiles, Kathy, Shor, Susan M, Burns, Kenya, Dowell, Corrie A., Gonzales, Gabriela “ Hope”, Flores, Melody, Newman, Lindsay, Wilk, Debora A., Ettlinger, Jason, Bomar, Jaccallene, Darji, Himani, Arroliga, Alejandro C. , Khandhar, Paras B., Kring, Elizabeth, Anderson, Edwin L., Nagy, Rosemary, Inja, Ravali R., Nawathe, Pooja , Tsing, Jennifer, Carr, Karen, Chaudhary, Anila , Guglielmino, Kathleen, Strom, Larisa, Chiotos, Kathleen, Lee, Giyoung , Burnett, Ryan H., Sydney, Guy I. , Traynor, Danielle M., Ahmed, Farzin, Deonarine, Christopher, Jones, Ashley, Shaikh, Mohammad-Ali , Preston, David A. , Chin, Jeanette, Milligan, Patrick S., Koglin, Joy M., Gibson, Regina, Johnson, Lana, Preston, Felicia, Scott, Crimson, Nungester, Bethany, Menter, Sarah, Wasilewski, A., Kaul, Viren , Austin, Praise, Rogner, Jaimie, Russo, Anthony J. , Ontai, Sidney , Contreras, Brian, Obinwanko, Uzoma, Amamasi, Nneka, Sharafi, Amir, Kaufman, Margit, Lobel, G, Gandhi, Nisha, AbdelAty, Amr M. , Shaji, Elizabeth, Lim, Kiana, Marte, Juan M., Sosa, Dani Ashley, Roth, Prerana , Litwin, Alain H. , Pariyadath, Anand, Moschella, Phillip , Llano, Trayson, Salas, Alan, Daube, Ariel , Korn, Michelle, Rajagopalan, Logi, Santos, Laura Jurema dos , Crandall, Christine , Stojanovski, Sasko, Michienzi, Kelly, Amer, Marwa , Dahhan, Talal, Kseibi, Eiad, Butt, Abid, Khurshid, Syed Moazzum, Rabee, Muath, Abujazar, Mohammed, Alghunaim, Razan, Abualkhair, Maal, AlFirm, Abeer Turki, Oulds, Franscene, Nandavar, Akshay, Wen, Andy , DaCar, Allie, Reilkoff, Ronald A., Eichen, Sarah, Goertzen, Lexie, Rajala, Scott, Feussom, Ghislaine, Domecq, Juan Pablo , Sharma, Mayank , Qamar, Shahraz , Morales, Diana J. Valencia , Khan, Syed Anjum , Jain, Nitesh , Wang, Christine, Kotekal, Dhatri, Sendi, Prithvi , Aulakh, Bhagat , Bandy, Jennifer A., Kreps, Lisa M., Bollinger, Dawn R., Nadiger, Meghana, Schauf, Victoria, Rich, Deana, Anderson, Harry L., Rajkumar, Dixy, Abunayla, Ali, Heiter, Jerrilyn, Zaren, Howard A. , Smith, Stephanie J., Lewis, Grant C., Seames, Lauren, Farlow, Cheryl, Miller, Judy, Broadstreet, Gloria, Terrill, Cindy, Montgomery, Brock, Reyes, Sydney A, Reyes, Summer M, Plattner, Alex, Martinez, Anthony , Allison, Micheal, Mittal, Aniket, Ruíz, Rafael Azuar , Skaanland, Aleta, Amzuta, Ioana, Shah, Amish , Modi, Ritu, Al-Khalisy, Hassan, Masuta, Pardeep , Schafer, Melissa , Wratney, Angela, Jones, Tracy L., Ayers, Shonda C., Harrell, Amy B., Brown, Brent R., Malone, Kassidy, Sinko, Lauren A, Hrarrell, Amy B, Settle, Lisa, Sears, Taylor J., Kuehne, Joshua, Garcia, Melinda, Beebe, Morgan, Herrera, Heather , Belden, Katherine A. , Baram, Michael , Weber, Devin , DePaola, Rosalie, Xia, Yuwei , Carter, Hudson, Tolley, A. E., Ferranti, Mary, House, Scott, Aldana, Isabella, Stulce, Casey , Chong, Grace , Ghavam, Ahmeneh , Baslanti, Tezcan Ozrazgat, Omalay, George, Hashemighouchani, Haleh , Cupka, Julie S , Hubbard, Janice, Nazir, Usman, Rampon, Garrett , Riggle, Jake, Dismang, Nathan, Sullivan, Janice, Morris, Sarah, Nason, Jennifer, Rahman, Rania Abdul, Mulrow, Mary, Gál, Tamás, Mahashabde, Manasi, Vagonis, Alexandra , Uber, Rebecca, Mahmud, Haseeb , Leightle, Stefan, Zhang, Zoe, Vissichelli, Nicole C. , O'Meara, A M Iqbal, Rocawich, Katie, Harris, Lynnette , Cusson, Bruce, Reeves, Brandon, Fanelli, Jessica, Disher, Nataya, Samant, Anusha, DeGroot, Chritian, Youshock, Evan, Ligon, R. Miller, McCartney, Katherine, Garcia, Julio, Iloabachie, Chidi, Flores, Kelsey, VanEenenaam, David P., Sands, Lauren , Sweatt, Nia, Fowler, Jacob , Fram, Madeline, Howard, Easton, Johnson, Kathleen N. , Udoh, Imoh, Nosow, Lillian, Howard, Lucy Winesett, Pham, Quan Duc Minh, Irfanullah, Aman, Ong, Tiffany, Enwezor, Chukwunyelu Henry, Dabagian, Hannah, Bansal, Vikas , Asghar, Muhammad S , Tekin, Aysun , Tripathi, Sandeep , Lombardo, Monica, Gharpure, Varsha , Chiotos, Kathleen , Bjornstad, Erica C. , Dapul, Heda , Montgomery, Vicki , Deo, Neha , Gajic, Ognjen , Kashyap, Rahul , Walkey, Allan J. , Group, Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator, Itagaki, Yuki , Galadanci, Hadiza , Kabara, Halima Salisu, Syed, Mashaal, Almazyad, Mohammed , Asfina, Kazi Nur , Cooper, Paul R. , Burke, Kathryn, Mohammed, Mustafa, Ashley, Dennis W. , Mosier, Jarrod , Lutrick, Karen , Dubrocq, Gueorgui , Nagy, Rosemary, Inja, Ravali R., Pedraza, Isabel , Carr, Karen, Gist, Katja M. , Chiotos, Kathleen, Blatz, Allison M. , Cheruku, Sreekanth , Preston, David, Gupta, Sandeep , Abdelaty, Amr, Rennert, Lior , Ramírez, Michelle , Verma, Sourabh , Stojanovski, Sasko D., Johnson, Kristin, Bawazeer, Mohammed Abdullah , Gupta, Manoj , Heneghan, Julia A. , Tang, Ben, Lal, Amos , O’Horo, John C. , Singh, Romil , Koritala, Thoyaja , Tarabichi, Yasir , Perzynski, Adam T. , Wang, Christine, Totapally, Balagangadhar , Nadiger, Meghana, Wall, Chris, Menon, Shina , McGuire, John K. , Anderson, Harry L., Miller, Judy, Lin, John C. H. , Montgomery, Brock, Ruiz, Rafael, Ross, Robert, Gupta, Neha , Brown, Brent , Tolley, Aaron, Tofil, Nancy M. , Mayampurath, Anoop , Bihorac, Azra , Ruppert, Matthew M. , McGonagill, Patrick W. , Galet, Colette , Wang, David , Allan, Lauren , Badheka, Aditya V. , Chegondi, Madhuradhar , Sullivan, Janice, Nason, Jennifer, Akhter, Murtaza , Kashiouris, Markos , Gal, Tamas, Karam, Oliver , Carvalho, Heloisa De, Khanna, Ashish K. , Garcia, Julio, Robinson, Samuel, Enwezor, Chukwunyelu Henry , Mendoza, Rafael
JAMA Pediatrics | October 3, 2022 | Volume: 176 | Issue: 12 | Pages: 1208
10.1001/jamapediatrics.2022.3611
ImportanceThere is limited evidence for therapeutic options for pediatric COVID-19 outside of multisystem inflammatory syndrome in children (MIS-C).ObjectiveTo determine whether the use of steroids within 2 days of admission for non–MIS-C COVID-19 in children is associated with hospital length of stay (LOS). The secondary objective was to determine their association with intensive care unit (ICU) LOS, inflammation, and fever defervescence.Design, Setting, and ParticipantsThis cohort study analyzed data retrospectively for children (<18 years) who required hospitalization for non–MIS-C COVID-19. Data from March 2020 through September 2021 were provided by 58 hospitals in 7 countries who participate in the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 registry.ExposureAdministration of steroids within 2 days of admission.Main Outcomes and MeasuresLength of stay in the hospital and ICU. Adjustment for confounders was done by mixed linear regression and propensity score matching.ResultsA total of 1163 patients met inclusion criteria and had a median (IQR) age of 7 years (0.9-14.3). Almost half of all patients (601/1163, 51.7%) were male, 33.8% (392/1163) were non-Hispanic White, and 27.9% (324/1163) were Hispanic. Of the study population, 184 patients (15.8%) received steroids within 2 days of admission, and 979 (84.2%) did not receive steroids within the first 2 days. Among 1163 patients, 658 (56.5%) required respiratory support during hospitalization. Overall, patients in the steroids group were older and had greater severity of illness, and a larger proportion required respiratory and vasoactive support. On multivariable linear regression, after controlling for treatment with remdesivir within 2 days, country, race and ethnicity, obesity and comorbidity, number of abnormal inflammatory mediators, age, bacterial or viral coinfection, and disease severity according to ICU admission within first 2 days or World Health Organization ordinal scale of 4 or higher on admission, with a random intercept for the site, early steroid treatment was not significantly associated with hospital LOS (exponentiated coefficient, 0.94; 95% CI, 0.81-1.09; P = .42). Separate analyses for patients with an LOS of 2 days or longer (n = 729), those receiving respiratory support at admission (n = 286), and propensity score–matched patients also showed no significant association between steroids and LOS. Early steroid treatment was not associated with ICU LOS, fever defervescence by day 3, or normalization of inflammatory mediators.Conclusions and RelevanceSteroid treatment within 2 days of hospital admission in a heterogeneous cohort of pediatric patients hospitalized for COVID-19 without MIS-C did not have a statistically significant association with hospital LOS.
Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients With COVID-19
Neha, Gupta,, Lisa, Settle,, R, Brown, Brent, L, Armaignac, Donna, Michael, Baram,, E, Perkins, Nicholas, Margit, Kaufman,, R, Melamed, Roman, B, Christie, Amy, C, Danesh, Valerie, L, Denson, Joshua, R, Cheruku, Sreekanth, Karen, Boman,, Vikas, Bansal,, K, Kumar, Vishakha, J, Walkey, Allan, P, Domecq, Juan, Rahul, Kashyap,, E, Aston, Christopher, Bansal, Vikas , Choudhry, Asad , Tonna, Joseph E. , Kaur, Nirmaljot , Danesh, Valerie , Mosier, Jarrod , Заболотских, И. Б. , Montgomery, Vicki , Heneghan, Julia A. , Menon, Shina , Gupta, Neha , Kovačević, Peđja , Lee‐Mateus, Alejandra Yu , Asghar, Muhammad Sohaib , O’Brien, Connor , Popadić, Višeslav , Shlomovich, Mark , Almazyad, Mohammed , Nawathe, Pooja , Lyons, Patrick G. , El‐Kassas, Mohamed , Tawheed, Ahmed , Pineda, Estela , Parameswaran, Sreejith , Iwasaki, Yudai , Galadanci, Hadiza , Kovačević, Bojan , Nenadić, Irina , Djuric, Marko , DiLorenzo, Madeline A. , Minear, Steven , Perkins, Nicholas , Fitzsimmons, Alec , Maldonado, Génessis , Tarabichi, Yasir , Redfern, Roberta E. , Vail, Emily A. , Dy, Rajany , Spuzzillo, Anthony , Galet, Colette , Akça, Ozan , Cavallazzi, Rodrigo , Pulsipher, Aaron M. , Domecq, Juan P, Tonna, Joseph E. , Bansal, Vikas , Yu Lee-Mateus, Alejandra , Kaur, Nirmaljot , Asghar, Muhammad S , Popadic, Viseslav , O'Brien, Connor G , Mosier, Jarrod M , Domecq Graces, Juan Pablo , Redfern, Roberta E , Pulsipher, Aaron M , Sines, B. , Menon, Shina , Settle, Lisa, Brown, Brent R., Armaignac, Donna Lee , Baram, Michael , Kaufman, Margit, Melamed, Roman , Christie, Amy B. , Denson, Joshua L. , Cheruku, Sreekanth , Boman, Karen , Kumar, Vishakha K. , Walkey, Allan J. , Domecq, Juan Pablo , Kashyap, Rahul , Aston, Christopher E. , Group, on behalf of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator
Critical Care Medicine | July 27, 2022 | Volume: 50 | Issue: 10 | Pages: e744-e758
OBJECTIVES: To determine the association of prior use of renin-angiotensin-aldosterone system inhibitors (RAASIs) with mortality and outcomes in hospitalized patients with COVID-19. DESIGN: Retrospective observational study. SETTING: Multicenter, international COVID-19 registry. Subjects: Adult hospitalized COVID-19 patients on antihypertensive agents (AHAs) prior to admission, admitted from March 31, 2020, to March 10, 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were compared between three groups: patients on RAASIs only, other AHAs only, and those on both medications. Multivariable logistic and linear regressions were performed after controlling for prehospitalization characteristics to estimate the effect of RAASIs on mortality and other outcomes during hospitalization. Of 26,652 patients, 7,975 patients were on AHAs prior to hospitalization. Of these, 1,542 patients (19.3%) were on RAASIs only, 3,765 patients (47.2%) were on other AHAs only, and 2,668 (33.5%) patients were on both medications. Compared with those taking other AHAs only, patients on RAASIs only were younger (mean age 63.3 vs 66.9 yr; p < 0.0001), more often male (58.2% vs 52.4%; p = 0.0001) and more often White (55.1% vs 47.2%; p < 0.0001). After adjusting for age, gender, race, location, and comorbidities, patients on combination of RAASIs and other AHAs had higher in-hospital mortality than those on RAASIs only (odds ratio [OR] = 1.28; 95% CI [1.19–1.38]; p < 0.0001) and higher mortality than those on other AHAs only (OR = 1.09; 95% CI [1.03–1.15]; p = 0.0017). Patients on RAASIs only had lower mortality than those on other AHAs only (OR = 0.87; 95% CI [0.81–0.94]; p = 0.0003). Patients on ACEIs only had higher mortality compared with those on ARBs only (OR = 1.37; 95% CI [1.20–1.56]; p < 0.0001). CONCLUSIONS: Among patients hospitalized for COVID-19 who were taking AHAs, prior use of a combination of RAASIs and other AHAs was associated with higher in-hospital mortality than the use of RAASIs alone. When compared with ARBs, ACEIs were associated with significantly higher mortality in hospitalized COVID-19 patients.
Variation in Use of High-Flow Nasal Cannula and Noninvasive Ventilation Among Patients With COVID-19
Garcia, Michael A. , Johnson, Shelsey W. , Sisson, Emily, Sheldrick, Christopher R, Kumar, Vishakha K. , Boman, Karen , Bolesta, Scott , Bansal, Vikas , Bogojevic, Marija , Domecq, J. P., Lal, Amos , Heavner, Smith F. , Lee, Donna, Anderson, Harry L, Investigators, from the Society of Critical Care Medicine's Discovery Viral Infection and Respiratory Illness Universal Study, Tierney, David M. , Заболотских, И. Б. , Asghar, Muhammad Sohaib , Galet, Colette , Lal, Amos , Bansal, Vikas , Asghar, Muhammad S , Domecq Graces, Juan Pablo , Sheldrick, Christopher R, Cheruku, Sreekanth , Anderson, Harry L, Denson, Joshua L. , Gajic, Ognjen , Kashyap, Rahul , Walkey, Allan J. , Investigators, from the Society of Critical Care Medicine's Discovery Viral Infection and Respiratory Illness Universal Study
Respiratory Care | June 7, 2022 | Volume: 67 | Issue: 8 | Pages: 929-938
BACKGROUND: The use of high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) for hypoxemic respiratory failure secondary to COVID-19 are recommended by critical-care guidelines; however, apprehension about viral particle aerosolization and patient self-inflicted lung injury may have limited use. We aimed to describe hospital variation in the use and clinical outcomes of HFNC and NIV for the management of COVID-19. METHODS: This was a retrospective observational study of adults hospitalized with COVID-19 who received supplemental oxygen between February 15, 2020, and April 12, 2021, across 102 international and United States hospitals by using the COVID-19 Registry. Associations of HFNC and NIV use with clinical outcomes were evaluated by using multivariable adjusted hierarchical random-effects logistic regression models. Hospital variation was characterized by using intraclass correlation and the median odds ratio. RESULTS: Among 13,454 adults with COVID-19 who received supplemental oxygen, 8,143 (60%) received nasal cannula/face mask only, 2,859 (21%) received HFNC, 878 (7%) received NIV, 1,574 (12%) received both HFNC and NIV, with 3,640 subjects (27%) progressing to invasive ventilation. The hospital of admission contributed to 24% of the risk-adjusted variation in HFNC and 30% of the risk-adjusted variation in NIV. The median odds ratio for hospital variation of HFNC was 2.6 (95% CI 1.4–4.9) and of NIV was 3.1 (95% CI 1.2-8.1). Among 5,311 subjects who received HFNC and/or NIV, 2,772 (52%) did not receive invasive ventilation and survived to hospital discharge. Hospital-level use of HFNC or NIV were not associated with the rates of invasive ventilation or mortality. CONCLUSIONS: Hospital variation in the use of HFNC and NIV for acute respiratory failure secondary to COVID-19 was great but was not associated with intubation or mortality. The wide variation and relatively low use of HFNC/NIV observed within our study signaled that implementation of increased HFNC/NIV use in patients with COVID-19 will require changes to current care delivery practices. (ClinicalTrials.gov registration NCT04323787.)
Metabolic Syndrome and Acute Respiratory Distress Syndrome in Hospitalized Patients With COVID-19
Gillet, A.S. , Zu, Yuanhao, Brown, Margo, Pham, Thaidan , Yoshida, Yilin , Douglas, Ivor S. , Moore, Mathew, Tea, Kevin, Wetherbie, Andrew, Stevens, Rachael, Lefante, John J., Shaffer, Jeffrey G. , Armaignac, Donna Lee , Belden, Katherine A. , Kaufman, Margit, Heavner, Smith F. , Danesh, Valerie , Hill, Catherine A. St., Boman, Karen , Bansal, Vikas , Kumar, Vishakha K. , Group, Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator, Mesland, Jean-Baptiste , Henin, Pierre , Petre, Hélène, Buelens, Isabelle, Gérard, A , Granado, Rolando Claure-Del, Vega-Terraza, Esdenka, Iturricha-Cáceres, Maria F., Garza, Rubén , Chan, Victoria , Gavidia, Oscar Y., Pachon, Felipe, Tawheed, Ahmed , Pineda, Estela , Guillen, Gabina María Reyes, Soto, Helin Archaga, Lizardo, Ana Karen Vallecillo, Segu, Smitha, Chakraborty, T., Joyce, Epcebha, Kasumalla, Phani Sreeharsha, Vadgaonkar, Girish, Ediga, Rekha, Basety, Shilpa, Dammareddy, Shwetha, Raju, Umamaheswara, Manduva, Janaki, Kolakani, Naresh, Sripathi, Shreeja , Chaitanya, Sheetal, Parameswaran, Sreejith , Parthiban, Magesh, Menu, P., Daga, Mardul Kumar, Agarwal, Munisha , Rohtagi, Ishan, Papani, Sridhar, Kamuram, Mahesh, Agrawal, Kamlesh Kumar , Baghel, Vijendra, Patel, K, Mohan, Surapaneni Krishna, Jyothisree, Ekambaram, Dalili, Nooshin , Nafa, Mohsen, Matsuda, Wataru , Suzuki, Reina , Horikita, Sho, Kodate, Akira, Takahashi, Yuki , Moriki, Koyo, Iwasaki, Yudai , Rodríguez‐Gutiérrez, René , Gonzale, Jose Gerardo, Salcido‐Montenegro, Alejandro , Hassan-Hanga, Fatimah , Gezawa, Abubakar Shehu, Kabir, Halima , Amole, Taiwo Gboluwaga , Haliru, Dalha Gwarzo, Ibrahim, Abdullahi S., Asghar, Muhammad Sohaib , Syed, Mashaal , Naqvi, Syed Anosh Ali, Заболотских, И. 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H., Weinert, Chauncey, Schoenrade, Nathan, Altaher, Abdulrahman, Mayar, Esmael, Aronson, Matthew, Cooper, Tyler, Logan, Monica, Miner, Brianna, Papo, Gisele, Siegal, Eric M., Runningen, Phyllis, Patel, Love , Melamed, Roman , Tierney, David M. , Raj, Vino S., Mazumder, Narayana, Hill, Catherine St., Kirkland, Lisa L., Schmitz, Nova J., Sigman, Alena, Hall, Joan, Raval, Abhijit, Franks, Andrea S. , Jarvis, Jennifer M., Kharbanda, Anmol, Jhajhria, Sunil, Fyffe, Zachary, Capizzi, Stephen A., Alicie, Bethany, Green, Martha, Corckarell, Lori, Drennan, A. M., Dubuque, Kathleen, Fambrough, Tonya, Gasaway, Nikole, Krantz, Briana, Nebi, Peiman, Orga, Jan, Serfass, Margaret, Simion, Alina, Warren, Kimberly R., Wheeler, Cassie, Woolman, C. 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A. Martinez, Parker, Brittany M, Quintanilla, Julio, Craig, Tara A, Clough, B., Jameson, J, Jones, Tacy L, Ayers, Shonda C., Harrell, Amy B., Brown, Brent R., Darby, Caleb, Page, Kristy, Brown, Amanda, McAbee, Jessie, Baram, Michael , Weber, Devin , DePaola, Rosalie, Xia, Yuwei , Carter, Hudson, Tolley, A. E., Ferranti, Mary, Steele, Mark P., Kemble, Laurie, Sethi, Joshua, Han, Chung Cheng, Pagliaro, Jaclyn , Husian, Abdurrahman, Zawaydeh, Qais , Sines, B. , Markotić, Dragana, Bošnjak, Ivana, Nicholson, Susannah E. , Jonas, Rachelle B., Dement, AnnaRose E, Tang, William , DeRose, Mark, Villarreal, Robert E, Dy, Rajany , Lardino, Alfredo, Sharma, Jill H., Czieki, Richard, Christopher, Julia, Lacey, Ryan, Mashina, Marwan , Patel, Kushal, Gomaa, Dina , Goodman, Micahel, Spuzzillo, Anthony , Shinn, John O., Baslanti, Tezcan Ozrazgat, Omalay, George, Hashemighouchani, Haleh , Cupka, Julie S , Galet, Colette , Hubbard, Janice, Nazir, Usman, Rampon, Garrett , Riggle, Jake, Dismag, Nathan, Lenhardt, Rainer, Cavallazzi, Rodrigo , Jerde, Ann, Black, Alexa, Polidori, A., Griffey, Haily, Winkler, J., Brenzel, Thomas, Alvarez, Rodger A, Alarocon-Calderon, Amarilys, Sosa, Marie Anne , Mahabir, Sunita, Patel, Mausam , Parker, Pauline, Admon, Andre, Hanna, Sinan, Pliakas, Maria , Wolski, Ann, Cirino, Jennifer, Geiger, Grant , Njai, Abdoulie , Saad, Baraa M., Chuan, Byron, Rawal, Sagar L, Piracha, Manal, Levin, Nicholas M. , Suslavich, Kayte , Tsolinas, Rachel , Fica, Zachary , Skidmore, Chloe R., Stapleton, Renee D., Dixon, Anne E. , Johnson, Olivia, Ardren, Sara S., Burns, Stephanie, Raymond, Anna, Gonyaw, Erika, Hodgdon, Kevin , Houseger, Chole, Lin, Benjamin R. , McQuesten, Karen, Grimm, Heidi Pecott-, Sweet, Julie, Ventrone, Sebastian, Khandelwal, Nita , Lovelace-Macon, Lara, Garimella, Navya, Dow, Denisse Bazan, Rahman, Rania Abdul, Mulrow, Mary, Wilfong, Erin M. , Vela, Kelsi, Harris, Lynne, Cusson, Bruce, Fowler, Jacob , VanEenenaam, David P., Mckinney, Glen , Udoh, Imoh, Johnson, Kathleen N. , Michelson, Andrew P. , Haulf, Sara S, Lynch, Lauren, Steinbery, Aaron, Braus, Nicholas, Pattan, Vishwanath , Papke, J, Jimada, Ismail, Mhid, Nida, Chakola, Samuel, Sheth, Kevin N., Ammar, Abdalla , Lopez, Victor Torres , Khosla, Akhil , Gautam, Samir C. , Lee‐Mateus, Alejandra Yu , Bansal, Vikas , Yu Lee-Mateus, Alejandra , Kaur, Nirmaljot , Asghar, Muhammad S , Redfern, Roberta E , Denson, Joshua L. , Mauvais‐Jarvis, Franck , Cheruku, Sreekanth , Deo, Neha , Walkey, Allan J. , Kashyap, Rahul , Group, Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator, Clevenbergh, Philippe Albert , Granado, Rolando Claure‐Del , Mercado, Jose A, Garza, Ruben, Chu, Eric, Chan, Victoria, El‐Kassas, Mohamed , Chakraborty, Tuhin, Cherian, Anusha , Menu, Priya A, Sanui, Masamitsu , Itagaki, Yuki , Shiga, Takuya , Camacho-Ortíz, Adrián , Galadanci, Hadiza , Syed, Mashaal, Musaeva, Tatiana Sergeevna , Bawazeer, Mohammed Abdullah , Alghunaim, Razan K, Almazyad, Mohammed , Asfina, Kazi Nur , Klašnja, Slobodan , Kovačević, Bojan , Teruel, Santiago Y, Sili, Uluhan , Ay, Pınar , Bird, Paige, Schoenrade, Nathan, Hall, Joan, Franks, Andrea, Drennan, Amelia, Warren, Kimberly, Ashley, Dennis W. , Sikora, Andrea , Bruning, Rebecca, Jones, Timothy W, Mosier, Jarrod , Lutrick, Karen , Vincent, Gregory, Howard, Christopher M. , Garner, Orlando , Mathew, Sindhu, Dubrocq, Gueorgui , Waikar, Sushrut S. , Leong, Michael, McGrath, Patrick J, Chilbert, Maya R. , Green, Cindy, Ihle, Rayan E, Martin, Shelda A., Gist, Katja M. , Chiotos, Kathleen , Blatz, Allison M. , Surani, Salim , White, Joshua, Khan, Aftab, Preston, David, Vachharajani, Vidula , Dugar, Siddharth , Sacha, Gretchen , Kind, Alexander, Gole, Susan, Gupta, Sandeep , Schorr, Christa , Siegler, James E. , Bartz, Raquel R. , Mehta, Sachin, Kaufman, Margit, Abdelaty, Amr, Yamane, David , Pariyadath, Anand, Olsen, Haley, Smith, Michael A. , Snow, William, Heneghan, Julia A. , Tang, Ben, Goyes, Daniela , Maldonado, Génessis , Khan, Hassan, Gajic, Ognjen , Tekin, Aysun , Lal, Amos , O’Horo, John C. , Singh, Romil , Nou, Abigail La, Zec, Simon , Guru, Pramod , Garcia, Juan, Yarrarapu, Siva Naga S. , Bergl, Paul A. , Peterson, Jennifer L, Perzynski, Adam T. , Wang, Christine, Matute, Carlos , Hamdan, Ahmad, Tejada, Angel, Tripathi, Sandeep , Inman, Terra, Moore, Danielle, Anderson, Harry L, Miller, Judy, Ruiz, Rafael, Ross, Robert, Joseph, Sam, Block, Jason, O’Brien, Connor , Carter, Kristina L, Olmos, Michael, Gupta, Neha , Darby, Caleb, Tolley, Aaron, Malhotra, Atul , Bice, Thomas J. , Bosnjak, Ivana, Vail, Emily A. , Tang, William, Villarreal, Roberto E., Patel, Kushal, Wakefield, Devin, Bihorac, Azra , Ruppert, Matthew M. , McGonagill, Patrick W. , Wang, David , Allan, Lauren , Badheka, Aditya V. , Chegondi, Madhuradhar , Akça, Ozan , Polidori, Allison, Winkler, Justin, Chanderraj, Rishi , Dandachi, Dima , Regunath, Hariharan , Camazine, Maraya , Saad, Baraa, Shah, Faraaz A , Tonna, Joseph E. , Lin, Benjamin, Pecott-Grimm, Heidi, West, T. Eoin , Caldwell, Ellen , Akhter, Murtaza , Khanna, Ashish , Lyons, Patrick G. , Lynch, Lauren M, Nguyen, Nguyet Minh , Papke, Jessica, Ammar, Mahmoud A , Dela Cruz, Charles S
JAMA Network Open | December 22, 2021 | Volume: 4 | Issue: 12 | Pages: e2140568
The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19
Christison, Amy L. , McGravery, Jeremy, Tekin, Aysun , Bolliger, Dawn, Kumar, Vishakha K. , Bansal, Vikas , Dapul, Heda , Bhalala, Utpal , Gharpure, Varsha , Heneghan, Julia A. , Gupta, Neha , Montgomery, Vicki , Arteaga, Grace M. , Choudhry, Asad , Kovačević, Tanja , Polić, Branka , Markić, Joško , Camazine, Maraya , Mosier, Jarrod , Menon, Shina , Asghar, Muhammad Sohaib , Shlomovich, Mark , Almazyad, Mohammed , Asfina, Kazi Nur , Galet, Colette , Carev, Dominko , Wen, Andy , Karam, Oliver , Levy, Emily, Bansal, Vikas , Gharpure, Varsha P , Asghar, Muhammad S , Tekin, Aysun , Mosier, Jarrod M , Karam, Oliver , Tripathi, Sandeep , Levy, Emily R. , Chiotos, Kathleen , Gist, Katja M. , Bjornstad, Erica C. , Walkey, Allan J. , Kashyap, Rahul , Menon, Shina
Hospital Pediatrics | November 1, 2021 | Volume: 11 | Issue: 11 | Pages: e297-e316
OBJECTIVE To describe the impact of obesity on disease severity and outcomes of coronavirus disease 2019 (COVID-19) among hospitalized children. METHODS This retrospective cohort study from the Society of Critical Care Medicine Viral Respiratory Illness Universal Study registry included all children hospitalized with COVID-19 from March 2020 to January 2021. Obesity was defined by Centers for Disease Control and Prevention BMI or World Health Organization weight for length criteria. Critical illness definition was adapted from National Institutes of Health criteria of critical COVID. Multivariate mixed logistic and linear regression was performed to calculate the adjusted odds ratio of critical illness and the adjusted impact of obesity on hospital length of stay. RESULTS Data from 795 patients (96.4% United States) from 45 sites were analyzed, including 251 (31.5%) with obesity and 544 (68.5%) without. A higher proportion of patients with obesity were adolescents, of Hispanic ethnicity, and had other comorbidities. Those with obesity were also more likely to be diagnosed with multisystem inflammatory syndrome in children (35.7% vs 28.1%, P = .04) and had higher ICU admission rates (57% vs 44%, P < .01) with more critical illness (30.3% vs 18.3%, P < .01). Obesity had more impact on acute COVID-19 severity than on multisystem inflammatory syndrome in children presentation. The adjusted odds ratio for critical illness with obesity was 3.11 (95% confidence interval: 1.8–5.3). Patients with obesity had longer adjusted length of stay (exponentiated parameter estimate 1.3; 95% confidence interval: 1.1–1.5) compared with patients without obesity but did not have increased mortality risk due to COVID-19 (2.4% vs 1.5%, P = .38). CONCLUSION In a large, multicenter cohort, a high proportion of hospitalized children from COVID-19 had obesity as comorbidity. Furthermore, obesity had a significant independent association with critical illness.
Characterization and Outcomes of Hospitalized Children With Coronavirus Disease 2019: A Report From a Multicenter, Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) Registry
Bhalala, Utpal , Boman, Karen , Kumar, Vishakha K. , Retford, Lynn, Blatz, Allison M. , Dapul, Heda , Sayed, Imran A., Gharpure, Varsha , Irby, Katherine , Sanders, Ronald C., Heneghan, Julia A. , Thomas, Melissa K., Gupta, Manoj , Oulds, Franscene, Arteaga, Grace M. , Levy, Emily R. , Gupta, Neha , Kaufman, Margit, AbdelAty, Amr M. , Shlomovich, Mark , O'Meara, A M Iqbal, Kuehne, Joshua, Menon, Shina , Khandhar, Paras B., Miller, Aaron S., Barry, Suzanne, Danesh, Valerie , Zammit, Kimberly, Stulce, Casey , McGonagill, Patrick W. , Bercow, Asher, Amzuta, Ioana, Gupta, Sandeep , Almazyad, Mohammed , Pierre, Louisdon , Sendi, Prithvi , Ishaque, Sidra , Nawathe, Pooja , Lyons, Patrick G. , Bello, Imam Wada , Ari, Judith Ben, Kovačević, Tanja , Bansal, Vikas, Brinton, John T. , Rk, Kashyap, Bansal, Vikas , Kovačević, Tanja , Tierney, David M. , Polić, Branka , Markić, Joško , Asghar, Muhammad Sohaib , Galet, Colette , Carev, Dominko , Wen, Andy , Karam, Oliver , Bansal, Vikas , Levy, Emily R , Gharpure, Varsha P , Asghar, Muhammad S , Karam, Oliver , Gist, Katja M. , Tripathi, Sandeep , Chiotos, Kathleen , Verma, Sourabh , Bjornstad, Erica C. , Tofil, Nancy M. , Abdelaty, Amr, Medar, Shivanand , Khanna, Ashish , Anderson, Harry L, Akhter, Murtaza , Chen, Catherine , Walkey, Allan J. , Bihorac, Azra , Zimmerman, Jerry J. , Menon, Shina
Critical Care Medicine | August 13, 2021 | Volume: 50 | Issue: 1 | Pages: e40-e51
Objectives: Multicenter data on the characteristics and outcomes of children hospitalized with coronavirus disease 2019 are limited. Our objective was to describe the characteristics, ICU admissions, and outcomes among children hospitalized with coronavirus disease 2019 using Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 registry. Design: Retrospective study. Setting: Society of Critical Care Medicine Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) registry. Patients: Children (< 18 yr) hospitalized with coronavirus disease 2019 at participating hospitals from February 2020 to January 2021. Interventions: None. Measurements and Main Results: The primary outcome was ICU admission. Secondary outcomes included hospital and ICU duration of stay and ICU, hospital, and 28-day mortality. A total of 874 children with coronavirus disease 2019 were reported to Viral Infection and Respiratory Illness Universal Study registry from 51 participating centers, majority in the United States. Median age was 8 years (interquartile range, 1.25–14 yr) with a male:female ratio of 1:2. A majority were non-Hispanic (492/874; 62.9%). Median body mass index (n = 817) was 19.4 kg/m2 (16–25.8 kg/m2), with 110 (13.4%) overweight and 300 (36.6%) obese. A majority (67%) presented with fever, and 43.2% had comorbidities. A total of 238 of 838 (28.2%) met the Centers for Disease Control and Prevention criteria for multisystem inflammatory syndrome in children, and 404 of 874 (46.2%) were admitted to the ICU. In multivariate logistic regression, age, fever, multisystem inflammatory syndrome in children, and pre-existing seizure disorder were independently associated with a greater odds of ICU admission. Hospital mortality was 16 of 874 (1.8%). Median (interquartile range) duration of ICU (n = 379) and hospital (n = 857) stay were 3.9 days (2–7.7 d) and 4 days (1.9–7.5 d), respectively. For patients with 28-day data, survival was 679 of 787, 86.3% with 13.4% lost to follow-up, and 0.3% deceased. Conclusions: In this observational, multicenter registry of children with coronavirus disease 2019, ICU admission was common. Older age, fever, multisystem inflammatory syndrome in children, and seizure disorder were independently associated with ICU admission, and mortality was lower among children than mortality reported in adults.
Coronavirus Disease 2019–Associated PICU Admissions: A Report From the Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study Registry*
Boman, Karen , Gharpure, Varsha , Dapul, Heda , Sayed, Imran A., Kuehne, Joshua, Heneghan, Julia A. , Gupta, Manoj , Khandhar, Paras B., Menon, Shina , Gupta, Neha , Kumar, Vishakha K. , Retford, Lynn, Bhalala, Utpal , Kovačević, Tanja , Polić, Branka , Markić, Joško , Asghar, Muhammad Sohaib , McGonagill, Patrick W. , Galet, Colette , Carev, Dominko , Ramírez, Michelle , Wen, Andy , Mayampurath, Anoop , Gharpure, Varsha P , Asghar, Muhammad S , Tripathi, Sandeep , Gist, Katja M. , Bjornstad, Erica C. , Kashyap, Rahul , Chiotos, Kathleen , Zimmerman, Jerry J. , Menon, Shina
Pediatric Critical Care Medicine | May 10, 2021 | Volume: 22 | Issue: 7 | Pages: 603-615
OBJECTIVES: To compare clinical characteristics and outcomes of children admitted to the PICU for severe acute respiratory syndrome coronavirus 2–related illness with or without multisystem inflammatory syndrome in children. The secondary objective was to identify explanatory factors associated with outcome of critical illness defined by a composite index of in-hospital mortality and organ system support requirement. DESIGN: Retrospective cohort study. SETTING: Thirty-eight PICUs within the Viral Infection and Respiratory Illness Universal Study registry from March 2020 to January 2021. PATIENTS: Children less than 18 years with severe acute respiratory syndrome coronavirus 2–related illness with or without multisystem inflammatory syndrome in children. MEASUREMENTS AND MAIN RESULTS: Of 394 patients, 171 (43.4%) had multisystem inflammatory syndrome in children. Children with multisystem inflammatory syndrome in children were more likely younger (2–12 yr vs adolescents; p < 0.01), Black (35.6% vs 21.9%; p < 0.01), present with fever/abdominal pain than cough/dyspnea (p < 0.01), and less likely to have comorbidities (33.3% vs 61.9%; p < 0.01) compared with those without multisystem inflammatory syndrome in children. Inflammatory marker levels, use of inotropes/vasopressors, corticosteroids, and anticoagulants were higher in multisystem inflammatory syndrome in children patients (p < 0.01). Overall mortality was 3.8% (15/394), with no difference in the two groups. Diagnosis of multisystem inflammatory syndrome in children was associated with longer duration of hospitalization as compared to nonmultisystem inflammatory syndrome in children (7.5 d[interquartile range, 5–11] vs 5.3 d [interquartile range, 3–11 d]; p < 0.01). Critical illness occurred in 164 patients (41.6%) and was more common in patients with multisystem inflammatory syndrome in children compared with those without (55.6% vs 30.9%; p < 0.01). Multivariable analysis failed to show an association between critical illness and age, race, sex, greater than or equal to three signs and symptoms, or greater than or equal to two comorbidities among the multisystem inflammatory syndrome in children cohort. Among nonmultisystem inflammatory syndrome in children patients, the presence of greater than or equal to two comorbidities was associated with greater odds of critical illness (odds ratio 2.95 [95% CI, 1.61–5.40]; p < 0.01). CONCLUSIONS: This study delineates significant clinically relevant differences in presentation, explanatory factors, and outcomes among children admitted to PICU with severe acute respiratory syndrome coronavirus 2–related illness stratified by multisystem inflammatory syndrome in children.
Outcomes of Patients With Coronavirus Disease 2019 Receiving Organ Support Therapies: The International Viral Infection and Respiratory Illness Universal Study Registry
Domecq, Juan Pablo , Lal, Amos , Sheldrick, Christopher R., Kumar, Vishakha K. , Boman, Karen , Bolesta, Scott , Bansal, Vikas , Garcia, Michael A. , Kaufman, Margit, Danesh, Valerie , Anderson, Harry L., Milligan, Patrick S., Denson, Joshua L. , Hill, Catherine A. St., Dodd, Kenneth W. , Gajić, Ognjen, Kashyap, Rahul , Tierney, David M. , Camazine, Maraya , Dapul, Heda , Gharpure, Varsha , Koritala, Thoyaja , Заболотских, И. Б. , Kovačević, Peđja , Asghar, Muhammad Sohaib , McGonagill, Patrick W. , El‐Kassas, Mohamed , Parameswaran, Sreejith , Iwasaki, Yudai , Nenadić, Irina , Djuric, Marko , Lutrick, Karen , Lumelsky, David , Minear, Steven , Tarabichi, Yasir , Dy, Rajany , Galet, Colette , West, T. Eoin , Wilfong, Erin M. , Ramírez, Michelle , Law, Anica C. , Lal, Amos , Bansal, Vikas , Denson, Joshua L , Kashyap, Rahul , Gharpure, Varsha P , Asghar, Muhammad S , Domecq Graces, Juan Pablo , Sheldrick, Christopher R., Harhay, Michael Oscar , Cheruku, Sreekanth , Banner‐Goodspeed, Valerie , Anderson, Harry L., Martin, Greg S. , Gajic, Ognjen , Walkey, Allan J.
Critical Care Medicine | January 29, 2021 | Volume: 49 | Issue: 3 | Pages: 437-448
OBJECTIVES: To describe the outcomes of hospitalized patients in a multicenter, international coronavirus disease 2019 registry. DESIGN: Cross-sectional observational study including coronavirus disease 2019 patients hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection between February 15, 2020, and November 30, 2020, according to age and type of organ support therapies. SETTING: About 168 hospitals in 16 countries within the Society of Critical Care Medicine’s Discovery Viral Infection and Respiratory Illness University Study coronavirus disease 2019 registry. PATIENTS: Adult hospitalized coronavirus disease 2019 patients who did and did not require various types and combinations of organ support (mechanical ventilation, renal replacement therapy, vasopressors, and extracorporeal membrane oxygenation). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary outcome was hospital mortality. Secondary outcomes were discharge home with or without assistance and hospital length of stay. Risk-adjusted variation in hospital mortality for patients receiving invasive mechanical ventilation was assessed by using multilevel models with hospitals as a random effect, adjusted for age, race/ethnicity, sex, and comorbidities. Among 20,608 patients with coronavirus disease 2019, the mean (± sd ) age was 60.5 (±17), 11,1887 (54.3%) were men, 8,745 (42.4%) were admitted to the ICU, and 3,906 (19%) died in the hospital. Hospital mortality was 8.2% for patients receiving no organ support ( n = 15,001). The most common organ support therapy was invasive mechanical ventilation ( n = 5,005; 24.3%), with a hospital mortality of 49.8%. Mortality ranged from 40.8% among patients receiving only invasive mechanical ventilation ( n =1,749) to 71.6% for patients receiving invasive mechanical ventilation, vasoactive drugs, and new renal replacement therapy ( n = 655). Mortality was 39% for patients receiving extracorporeal membrane oxygenation ( n = 389). Rates of discharge home ranged from 73.5% for patients who did not require organ support therapies to 29.8% for patients who only received invasive mechanical ventilation, and 8.8% for invasive mechanical ventilation, vasoactive drugs, and renal replacement; 10.8% of patients older than 74 years who received invasive mechanical ventilation were discharged home. Median hospital length of stay for patients on mechanical ventilation was 17.1 days (9.7-28 d). Adjusted interhospital variation in mortality among patients receiving invasive mechanical ventilation was large (median odds ratio 1.69). CONCLUSIONS: Coronavirus disease 2019 prognosis varies by age and level of organ support. Interhospital variation in mortality of mechanically ventilated patients was not explained by patient characteristics and requires further evaluation.