Diferenças entre crianças com infecção respiratória aguda grave com ou sem infecção por SARS-CoV-2

Abstract

Aim: To compare clinical features and outcome of children with severe acute lower respiratory infection (ALRI) with or without SARS-CoV-2 infection admitted to Paediatric Intensive Care Unit (PICU). Methods: For this retrospective cohort study, all children aged<17 years admitted with severe ALRI at a PICU, in Salvador, Brazil were evaluated. Investigation of SARS-CoV-2 infection was performed by real-time reversetranscription PCR. Clinical data, physical findings upon admission and outcome were registered. Patients were categorized by with or without SARS-Cov-2 infection. Outcomes were death and invasive mechanical ventilation (IMV). Results: We enrolled 210 patients, whose median age was 2.8 years (IQR: 7.1 months–6.2 years). IMV was used in 33 (15.7%; 95%CI 11.3%-21.1%) patients. Eight (3.8%; 95%CI 1.8%-7.1%) cases died. 62 patients (29.5%) tested positive for SARS-CoV-2. Male gender (67.7% vs. 52.7%, P=0.045) and sickle cell disease (6.5% vs. 0%, P=0.007) were associated with SARS-CoV-2 infection. Wheezing upon admission was more common in patients without SARS-CoV-2 infection (38.5% vs. 21.0%, P=0.01). IMV was more frequent among patients with SARS-CoV-2 infection (25.8% vs. 11.5%, P=0.009) as well as death (8.1% vs. 2.0%, P=0.05). Conclusion: Children with severe ALRI infection with SARS-CoV-2 need IMV more frequently than those without it.