Table IX.

Narrative of deaths

An 11-year-old male patient with intermittent asthma, asthma, seizure disorder, developmental delay, and a gastrostomy tube was admitted with a 3-day history of fever, cough, wheezing, dyspnea, and increased seizure frequency. He was started on high-flow nasal cannula, but by the first hospital day, he required intubation for mechanical ventilation. He was noted to have coinfection with rhinovirus as well as SARS-CoV-2. He received methylprednisolone on admission and was on a steroid taper throughout this hospitalization. A 10-day course of remdesivir and a single dose of anakinra were also given. He developed line-associated Enterococcus faecalis bacteremia and also was noted to have a right femoral deep-vein-thrombosis, for which he received antibiotics and anticoagulation, respectively. He died on hospital day 58.

An 11-year-old-male patient with metastatic osteosarcoma on palliative chemotherapy with baseline nasal-cannula oxygen requirement presented with dyspnea and cough of 1-day duration. He was immediately intubated and mechanically ventilated for respiratory failure per the family's request. Care was withdrawn approximately 1 week later, and the patient died from respiratory failure due to a combination of lung metastases and SARS-CoV-2 infection.

A 3-month-old female patient with pulmonary hypertension, large atrial septum defect, and a moderate patent ductus arteriosus was admitted with a 1-day history of cough, fever, and dyspnea. She was initially started on nasal-cannula; however, soon after admission, she developed tachypnea and desaturations and was subsequently intubated for mechanical ventilation. She received a 10-day course of remdesivir as well as intravenous immunoglobulin. She developed acute kidney injury, thrombocytopenia, and line-associated Enterococcus faecalis bacteremia. She remained mechanically ventilated and died on hospital day 30.

An 18-year-old female patient with morbid obesity, hypertension, and intermittent asthma presented with 8-day history of cough, fever, and dyspnea. She was immediately intubated and mechanically ventilated in the ICU. She had evidence of acute kidney injury and acute respiratory distress syndrome. She was started on hydroxychloroquine and azithromycin, but these were discontinued after 2 days. She received a 5-day course of methylprednisolone and a single dose of tocilizumab. However, she remained mechanically ventilated and died on hospital day 38.

A 20-year-old male patient with a medical history of intermittent asthma was admitted with respiratory distress. He had been ill for 21 days before hospital presentation with fever, cough, wheezing, myalgia, dyspnea, vomiting, fatigue, and neck swelling. He was immediately intubated and mechanically ventilated after arriving at the intensive care unit. He had evidence of thrombocytopenia, acute respiratory distress syndrome, and acute kidney injury. He received empiric antibiotic therapy, methylprednisolone, and convalescent plasma but died on hospital day 2.

A 5-month-old male patient with no medical history was admitted after he was found to be unresponsive and limp while at home. No proceeding symptoms or known exposure to COVID-19 was reported. On hospital presentation, he was immediately intubated and started on mechanical ventilation as well as epinephrine, norepinephrine, and vasopressin. In addition to the SARS-CoV-2 infection, he was found to have parainfluenza infection. He received empiric antibiotic therapy with ceftriaxone and vancomycin. Five days into his hospitalization, he developed severe thrombocytopenia and acute kidney injury. At that time, he was started on a 6-day course of hydroxychloroquine. One week into his hospitalization, he was noted to have a Staphylococcus epidermidis line-associated bacteremia as well as Stenotrophomonas maltophilia pneumonia. Despite these interventions, he remained mechanically ventilated. He was given convalescent plasma on hospital day 29. He died shortly after a 31-day hospitalization.

A 10-year-old male patient with a medical history of intermittent asthma was admitted with fever, cough, wheezing, and dyspnea for 7 days before presentation. The patient was noted to be in significant respiratory distress with hypoxia. He was admitted to the intensive care unit with acute respiratory distress syndrome and was mechanically ventilated and had left-sided chest tube placement. He had evidence of acute kidney injury with elevated creatinine. He received methylprednisolone and empiric antibiotic therapy with ceftaroline. He died on hospital day 2 due to respiratory distress.