TABLE 2.
Comparisons of Survivors’ vs Nonsurvivors in Children with COVID-19
| Parameters | All Patients (n = 335) | Survivors (n = 291) | Nonsurvivors (n = 44) | P |
|---|---|---|---|---|
| Age, month n (%) | ||||
| ≤12, n (%) | 76 (22.69) | 66 (22.68) | 10 (22.73) | 0.96 |
| 13–60, n (%) | 76 (22.69) | 66 (22.68) | 10 (22.73) | |
| 61–120, n (%) | 45 (13.43) | 38 (13.06) | 7 (15.91) | |
| ≥121, n (%) | 138 (41.19) | 121 (41.58) | 17 (38.64) | |
| Male, n (%) | 180 (53.73) | 155 (53.26) | 25 (56.82) | 0.66 |
| Comorbidities n (%) | 215 (64.18) | 176 (60.48) | 39 (88.64) | 0.00 |
| ≥2 Comorbidities n (%) | 117 (34.93) | 92 (31.62) | 25 (56.82) | 0.00 |
| Epilepsy, n (%) | 62 (18.51) | 54 (18.56) | 8 (18.18) | 0.95 |
| Developmental delay, n (%) | 54 (16.12) | 45 (15.46) | 9 (20.45) | 0.40 |
| Medical complexitya, n (%) | 47 (14.13) | 35 (12.03) | 12 (27.27) | 0.01 |
| Congenital heart disease, n (%) | 27 (8.06) | 20 (6.87) | 7 (15.91) | 0.04 |
| Chronic lung disease, n (%) | 25 (7.46) | 21 (7.22) | 4 (9.09) | 0.66 |
| Immune suppression, n (%) | 21 (6.27) | 14 (4.81) | 7 (15.92) | 0.01 |
| Obesity, n (%) | 21 (6.27) | 19 (6.53) | 2 (4.55) | 0.61 |
| Malignancy, n (%) | 21 (6.27) | 12 (4.12) | 9 (20.45) | 0.00 |
| Diabetes, n (%) | 16 (4.78) | 14 (4.81) | 2 (4.55) | 0.94 |
| Asthma, n (%) | 14 (4.18) | 12 (4.12) | 2 (4.55) | 0.90 |
| Endocrine disease, n (%) | 17 (5.07) | 14 (4.81) | 3 (6.82) | 0.58 |
| Chronic kidney disease, n (%) | 11 (3.28) | 9 (3.09) | 2 (4.55) | 0.61 |
| Metabolic disease, n (%) | 11 (3.28) | 9 (3.09) | 2 (4.55) | 0.61 |
| Down syndrome, n (%) | 9 (2.69) | 6 (2.06) | 3 (6.82) | 0.07 |
| Hematologic disease, n (%) | 3 (0.90) | 3 (1.03) | 0 (0.00) | 1.00 |
| Psychiatric disease, n (%) | 2 (0.60) | 1 (0.34) | 1 (2.27) | 0.12 |
| Post-transplantation, n (%) | 2 (0.60) | 2 (0.69) | 0 (0.00) | 0.58 |
| PRISM-IV, median (IQR) | 7 (2–16) | 6 (2–12) | 31.5 (13–63) | 0.00 |
| OFI n (%) | 0.00 | |||
| 1–2 organ failure n (%) | 160 (47.76) | 148 (50.86) | 12 (27.27) | |
| 3–4 organ failure n (%) | 63 (18.81) | 44 (15.12) | 19 (43.18) | |
| 5–6 organ failure n (%) | 19 (5.67) | 6 (2.06) | 13 (29.55) | |
| Severity of illness n (%) | ||||
| Mild n (%) | 72 (21.49) | 72 (24.74) | 0 (0.00) | 0.00 |
| Moderate n (%) | 54 (16.12) | 54 (18.56) | 0 (0.00) | |
| Severe n (%) | 104 (31.04) | 96 (32.99) | 8 (18.18) | |
| Critical n (%) | 105 (31.34) | 69 (23.71) | 36 (81.82) | |
| Vital signs, mean ± SDS | ||||
| Heart rate (beats/min), mean ± SD | 128.65 ± 30.8 | 127.28 ± 29.94 | 137.81 ± 35.04 | 0.04 |
| Respiratory rate (breaths/min) mean ± SD | 38.79 ± 14.1 | 38.49 ± 13.69 | 41.00 ± 16.85 | 0.30 |
| SBP mm Hg mean ± SD | 98.92 ± 20.47 | 99.74 ± 19.31 | 93.57 ± 26.54 | 0.14 |
| DBP mm Hg mean ± SD | 61.21 ± 15.37 | 61.90 ± 14.77 | 56.70 ± 18.42 | 0.04 |
| SPO2, mean ± SD | 91.41 ± 8.83 | 91.61 ± 9.04 | 90.14 ± 7.30 | 0.31 |
| Laboratory finding | ||||
| White blood cell count, × 109/L, mean ± SD | 10887.73 ± 7847.97 | 10829.42 ± 7774.51 | 11273.39 ± 8401.63 | 0.73 |
| Lymphocyte count, × 109/L median (IQR) | 1680 (950–3300) | 1750 (1012–3400) | 1200 (656–2300) | 0.00 |
| Neutrophil count, × 109/L, median (IQR) | 5240 (2750–9700) | 5430 (3000–10287) | 3450 (1090–7790) | 0.00 |
| Platelet count, × 109/L, mean ± SD | 267.40 ± 147.48 | 273.55 ± 140.09 | 226.88 ± 185.99 | 0.12 |
| Hemoglobin, mean ±SD | 11.17 ± 2.25 | 11.25 ± 2.20 | 10.64 ± 2.54 | 0.09 |
| Hematocrit, mean ±SD | 33.69 ± 6.76 | 33.87 ± 6.57 | 32.50 ± 7.85 | 0.21 |
| Aspartate aminotransferase, U/L, median (IQR) | 36 (25–65) | 35 (25–58) | 69.5 (35–150) | 0.00 |
| Alanine aminotransferase, U/L, median (IQR) | 25 (15–45) | 23.5 (15–41) | 33.5 (22–115) | 0.00 |
| Urea, mg/dl, median (IQR) | 21 (15–32) | 21 (15–30) | 30 (16–47) | 0.01 |
| Creatinine, mg/dl, median (IQR) | 0.47 (0.3–0.68) | 0.47 (0.29–0.67) | 0.49 (0.37–1.08) | 0.04 |
| Sodium mEq/L, mean ±SD | 137.65 ± 5.41 | 137.41 ± 5.25 | 139.27 ± 6.20 | 0.03 |
| Potassium mEq/L, mean ±SD | 4.18 ± 0.74 | 4.20 ± 0.73 | 4.06 ± 0.82 | 0.24 |
| Albumin, mg/dl, mean ±SD | 3.65 ± 0.62 | 3.70 ± 0.60 | 3.31 ± 0.64 | 0.00 |
| Creatine kinase, U/L, median (IQR) | 103 (48–221) | 101 (50–221) | 120 (46–264) | 0.79 |
| Lactate dehydrogenase, U/L, median (IQR) | 353 (275–526) | 337 (272–500) | 475 (356–789) | 0.00 |
| Amylase, U/L, median (IQR) | 45 (28–77) | 42 (27–72) | 61 (31–129) | 0.06 |
| Lipase, U/L, median (IQR) | 28 (13–48) | 24 (11–41) | 45 (21–99) | 0.01 |
| C-reactive protein, mg/dl, median (IQR) | 2.1 (0.42–8.19) | 1.88 (0.39–7.6) | 4.93 (1.1–16.03) | 0.00 |
| Procalcitonin, ng/mL, median (IQR) | 0.32 (0.1–2.3) | 0.28 (0.1–1.35) | 2.28 (0.31–16.8) | 0.00 |
| D-dimer, mg/dl, median (IQR) | 1 (0.54–2.26) | 0.97 (0.5–1.97) | 2.08 (1–3.63) | 0.00 |
| Troponin, median (IQR) | 3.3 (0.13–13) | 3.9 (0.15–13.3) | 1.65 (0.1–11.85) | 0.51 |
| Ferritin, mg/dl, median (IQR) | 224 (67–555) | 194.5 (65.5–487.25) | 565 (129.5–1413) | 0.00 |
| Fibrinogen, mg/dl, median (IQR) | 321 (234–447) | 329 (241–440) | 305.5 (156–466) | 0.24 |
| Prothrombin time, s, mean ± SDS | 14.69 ± 6.01 | 14.51 ± 4.73 | 15.90 ± 11.48 | 0.47 |
| APTT, s, mean ± SD | 30.36 ± 10.43 | 30.09 ± 9.45 | 32.10 ± 15.40 | 0.25 |
| Pro-BNP, median (IQR) | 550 (116–2520) | 456 (112–1782) | 3126 (296–7444) | 0.02 |
| Creatine kinase–MB, U/L, median (IQR) | 3.7 (0.94–20.2) | 3.36 (0.95–19) | 4.63 (0.87–27) | 0.60 |
| IL-6, median (IQR) | 34.4 (11.3–72.28) | 29.7 (9–66) | 55.5 (28.5–1234) | 0.05 |
| Baseline blood gases | ||||
| pH, mean ±SD | 7.33 ± 0.12 | 7.33 ± 0.12 | 7.32 ± 0.13 | 0.34 |
| pCO2, mm Hg, mean ± SD | 44.51 ± 17.1 | 44.27 ± 16.66 | 36.12 ± 19.88 | 0.51 |
| HCO3, mm Hg, mean ± SD | 22.38 ± 6.19 | 22.36 ± 5.97 | 22.55 ± 7.60 | 0.85 |
| Lactate, mmol/L, median (IQR) | 1.8 (1.3–2.74) | 1.8 (1.3–2.6) | 2.55 (1.5–4.1) | 0.00 |
| pARDS n (%) | 0.00 | |||
| Mild, n (%) | 67 (20.00) | 63 (21.65) | 4 (9.09) | |
| Moderate, n (%) | 38 (11.34) | 33 (11.34) | 5 (11.36) | |
| Severe, n (%) | 57 (17.01) | 26 (8.93) | 31 (70.45) | |
| Superinfections | ||||
| Gram-positive,n (%) | 37 (11.04) | 29 (9.97) | 8 (18.18) | 0.11 0.010.11 |
| Gram-negative,n (%) | 37 (11.04) | 27 (9.28) | 10 (22.73) | |
| Fungi,n (%) | 20 (5.97) | 15 (5.15) | 5 (11.36) | |
| Treatment | ||||
| Favipiravir, n (%) | 164 (48.96) | 134 (46.05) | 30 (68.18) | 0.01 |
| Oseltamivir, n (%) | 44 (13.13) | 41 (14.09) | 3 (6.82) | 0.18 |
| Lopinavir/ritonavir, n (%) | 32 (9.55) | 28 (9.62) | 4 (9.09) | 0.91 |
| Remdesivir, n (%) | 27 (8.08) | 24 (8.28) | 3 (6.82) | 0.74 |
| Hydroxychloroquine, n (%) | 61 (18.21) | 54 (18.56) | 7 (15.91) | 0.67 |
| Glucocorticoid therapy, n (%) | 162 (48.36) | 134 (46.05) | 28 (63.6) | 0.03 |
| IVIG, n (%) | 75 (22.39) | 57 (19.59) | 18 (40.91) | 0.00 |
| Convalescent plasma transfusion, n (%) | 8 (2.39) | 6 (2.06) | 2 (4.55) | 0.32 |
| Anakinra, n (%) | 3 (0.9) | 3 (1.03) | 0 (0.00) | 0.50 |
| Colchicine, n (%) | 3 (0.9) | 3 (1.03) | 0 (0.00) | 0.50 |
| Tocilizumab, n (%) | 2 (0.6) | 2 (0.69) | 0 (0.00) | 0.58 |
| Anticoagulation, n (%) | 177 (52.84) | 148 (50.86) | 29 (65.91) | 0.06 |
| Inotrope treatment, n (%) | 84 (25.07) | 42 (14.43) | 42 (95.45) | 0.00 |
| Maximum Vasoactive inotrope score, median (IQR) |
30 (15–50) | 18.75 (10–30) | 50 (26.25–205) | 0.00 |
| Maximum respiratory support | ||||
| None, n (%) | 38 (11.34) | 38 (13.06) | 0 (0.00) | 0.00 |
| Oxygen only, n (%) | 49 (14.63) | 49 (16.84) | 0 (0.00) | |
| High-flow oxygen, n (%) | 82 (24.48) | 81 (27.84) | 1 (2.27) | |
| Noninvasive ventilation, n (%) | 43 (12.84) | 43 (14.78) | 0 (0.00) | |
| Invasive ventilation, n (%) | 118 (35.22) | 79 (27.15) | 39 (88.64) | |
| HFOV, n (%) | 5 (1.49) | 1 (0.34) | 4 (9.09) | |
| Other respiratory support | ||||
| Prone position, n (%) | 80 (23.88) | 60 (20.62) | 20 (45.45) | 0.00 |
| Recruitment, n (%) | 34 (10.15) | 21 (7.22) | 13 (29.55) | 0.00 |
| Surfactant, n (%) | 5 (1.49) | 2 (0.69) | 3 (6.82) | 0.00 |
| Extracorporeal treatment | ||||
| Renal replacement therapy, n (%) | 17 (5.07) | 3 (1.03) | 14 (31.82) | 0.00 |
| Plasma exchange, n (%) | 22 (6.57) | 14 (4.81) | 8 (18.18) | 0.00 |
| Hemadsorption, n (%) | 2 (0.60) | 1 (0.34) | 1 (2.27) | 0.12 |
| ECMO, n (%) | 5 (1.49) | 2(0.69) | 3 (6.82) | 0.00 |
| PICU stay, median (IQR) | 7 (4–15) | 7 (4–14) | 11 (6–19) | 0.01 |
| Hospital stay,median (IQR) | 14 (8–24) | 14 (8–23) | 15 (10–37) | 0.31 |
APTT indicates Activated Partial Thromboplastin Time; BNP, brain natriuretic peptide; DBP, diastolic blood pressure; ECMO, extracorporeal membrane oxygenation; HFOV, High-frequency oscillatory ventilation; IQR, interquartile range; OFI, organ failure Index; IVIG, intravenous immunoglobulin; SBP, systolic blood pressure; SD, standard deviation; pARDS, pediatric acute respiratory distress syndrome; PRISM-IV, Pediatric Risk of Mortality IV.
a
Medical complexity: Defined as children who had a long-term dependence on technological support (including tracheostomy, etc).