Table 1.
Characteristics of patients with SARS-CoV-2 infection admitted to Spanish PICUs
| All patients (N = 50) | Patients requiring MV 14/50 (28%) | Patients not requiring MV 36/50 (72%) | p value | |
|---|---|---|---|---|
| Medical history | ||||
| Sex (male) | 31/50 (62%) | 11/14 (78.6%) | 20/36 (55.6%) | 0.197 |
| Age (years) median (IQR) | 6.7 (1.5–11.8) | 2.8 (0.4–9.5) | 8.6 (4.1–12.6) | 0.049 |
| Weight (kg) median (IQR) | 27 (12.3–41.5) | 19 (6.8–35.5) | 29.5 (15–44.5) | 0.163 |
| Previously healthy | 38/50 (76%) | 6/14 (42.9%) | 32/36 (88.9%) | 0.002 |
| Cause of admission | ||||
| Hemodynamic instability | 23/50 (46%) | 6/14 (42.9%) | 17/36 (47.2%) | 0.781 |
| Respiratory difficulty | 20/50 (40%) | 10/14 (71.4%) | 10/36 (27.8%) | 0.009 |
| Neurological symptoms | 1/50 (2%) | 0/14 (0%) | 1/36 (2.8%) | 1 |
| Clinic upon the first 24 h of admission to PICU | ||||
| ARDSa | 9/49 (18.4%) | 7/13 (53.8%) | 2/36 (5.6%) | 0.001 |
| Shock | 25/50 (50%) | 6/14 (42.9%) | 19/36 (52.8%) | 0.529 |
| PMIS | 27/50 (54%) | 4/14 (28.6%) | 23/36 (63.9%) | 0.031 |
| Renal failure | 8/50 (16%) | 3/14 (21.4%) | 5/36 (13.9%) | 0.670 |
| Heart dysfunction | 17/50 (34%) | 7/14 (50%) | 10/36 (27.8%) | 0.136 |
| PRISM III | 7 (4–13) | 9 (4–10.5) | 7 (4–10) | 0.302 |
| p-SOFA Median (IQR) | 4 (2–6) | 6.5 (4–10.5) | 3 (1–5) | 0.008 |
| Critical care needs | ||||
| HFNCa | 20/49 (50%) | 6/14 (42.9%) | 14/35 (40%) | 0.854 |
| NIVa | 9/48 (18.8%) | 3/14 (21.4%) | 6/34 (17.6%) | 0.760 |
| Blood product transfussiona | 11/48 (22.9%) | 5/14 (35.7%) | 6/34 (17.6%) | 0.258 |
| Vasoactive drugsa | 28/49 (57.1%) | 9/14 (64.3%) | 19/35 (54.3%) | 0.750 |
| Laboratory markersb | ||||
| Total leukocytes (/mcl) Median (IQR) | 9260 (5645–14,460) | 7860 (3757–11,375) | 9380 (6907–14,870) | 0.196 |
| Lymphocytes (/mcl) Median (IQR) | 1026 (420–2593) | 738 (313–4201) | 1168 (450–2601) | 0.712 |
| PCT (mcg/L) Median (IQR) | 6 (0.6–16.1) | 1.5 (0.2–20) | 7 (1.5–18.9) | 0.170 |
| CRP (mg/dl) median (IQR) | 13.9 (4.9–27) | 7.1 (0.3–22.6) | 19.1 (7.1–27.2) | 0.077 |
| Pharmacological management | ||||
| Antibiotica | 43/46 (93.5%) | 12/12 (100%) | 31/34 (91.2%) | 0.557 |
| Lopinavir-ritonavira | 22/44 (50%) | 6/12 (50%) | 16/32 (50%) | 1 |
| Remdesivira | 4/43 (9.3%) | 3/12 (25%) | 1/31 (3.2%) | 0.059 |
| Hydroxychloroquinea | 29/46 (63%) | 10/12 (83.3%) | 19/34 (55.9%) | 0.163 |
| Steroidsa | 32/44 (72.7%) | 9/12 (75%) | 23/32 (71.9%) | 1 |
| Intravenous Immunoglobulinsa | 15/44 (34.1%) | 2/12 (16.7%) | 13/32 (40.6%) | 0.171 |
| Tocilizumaba | 14/43 (32.6%) | 6/12 (50%) | 8/31 (25.8%) | 0.160 |
Patients requiring mechanical ventilation and patients not requiring mechanical ventilation are compared. ARDS was defined according to the Pediatric Acute Respiratory Distress Syndrome Consensus Recommendations from the Pediatric Acute Lung Injury Consensus Conference. PMIS was defined according to the Royal College of Paediatrics and Child Health. Shock was defined as blood pressure below 5th percentile reference values for age or the need of vasoactive drugs to maintain blood pressure in normal range or by the existence of signs of tissue hypoperfusion despite adequate fluid resuscitation. Renal failure was defined according to the KDIGO guidelines as the presence of urine output below 0.5 ml/kg/h for more than 6 h or as an increase on serum creatinine by 0.3 mg/dl within 48 h or 1.5 baseline values. Heart dysfunction was defined using echocardiography as the existence of global or segmental motion abnormalities, dilated ventricles, reduced ejection fraction or by the presence of pericardial effusion. p-SOFA scores were calculated using the information of the first 24 h of admission
IQR interquartile range, ADRS acute respiratory distress syndrome, PMIS pediatric multisystem inflammatory syndrome, HFNC high flow nasal cannula, NIV non invasive ventilation, MV mechanical ventilation, PCT procalcitonin, CRP C-reactive protein
aSome data were not available for all patients
bLaboratory markers were available in 48 out of 50 patients