ASPECTOS CLÍNICOS-NUTRICIONAIS E DESFECHOS DA COVID-19 EM PACIENTES PEDIÁTRICOS ONCOLÓGICOS E NÃO ONCOLÓGICOS

Abstract

Introduction: COVID-19, a pandemic disease recognized by the World Health Organization in mid-2019, affects individuals of all age groups and physiological conditions. In the pediatric population, the most severe forms of the disease have been described mainly in children and adolescents with comorbidities and in the presence of immunosuppressive treatments. Objective: To analyze the clinical and nutritional aspects in oncology and non-oncology pediatric hospitalized patients during SARS-CoV-2 infection and to verify the association with the clinical outcomes of COVID-19. Methods: This was a dynamic cohort study, in which children and adolescents of both sexes, aged 2 to 18 years, with laboratory diagnosis of COVID-19 and followed up in hospital units in the cities of Salvador (Bahia) and Natal (Rio Grande do Norte) from July 2020 to June 2021 were evaluated. Demographic data were collected remotely, by telephone contact with parents/guardians; clinical, anthropometric and nutritional screening data by STRONGKids were obtained from hospital records. Subsequently, the patients admitted to the study were categorized according to exposure into oncological and non-oncological. As for the outcomes related to COVID-19, we investigated hospitalization in a clinical bed or ICU, length of stay (< 14 days or ≥14 days), criticality (critical and non-critical) and discharge/healing or death. The Chi-square test or Fisher's exact test were used to compare independent groups to verify the association between categorical variables. For the Poisson regression, the Relative Risk (RR) of cancer patients presenting any of the investigated outcomes was verified. The SPSS software version 20.0 was used for statistical data processing. Results: We evaluated 83 patients, 16 (19.3%) of whom were oncologic, and most of whom were diagnosed with type B acute lymphoid leukemia (87.5%). No statistically significant differences were found between groups regarding demographic or nutritional variables. Poisson regression found an association between cancer and length of stay ≥14 days (RR 4.30; 95% CI 1.46 - 15.6; p=0.013), criticality of COVID-19 (RR 3.82; 95% CI 1.66 - 30.9; p= 0.010) and death (RR 3.42; 95% CI 0.94 - 9.96; p=0.035). Conclusion: Pediatric oncology patients infected with SARS-CoV-2 had longer hospital stay, higher frequency of critical illness and death related to COVID-19.