Covid-19 em pacientes pediátricos atendidos no sul do Brasil : epidemiologia, achados clínicos e fatores associados à gravidade

Introdução: Há poucos dados na literatura acerca do acometimento da população pediátrica pela covid-19, principalmente em países em desenvolvimento. Objetivos: Descrever as características epidemiológicas e evolução clínica de crianças hospitalizadas com covid-19, bem como identificar os fatores de risco para doença grave. Métodologia: Foram analisadas todas as internações de pacientes pediátricos ocorridas entre março e dezembro de 2020 na região sul do Brasil com RT-PCR positivo para SARS-CoV-2. Os dados foram extraídos de um banco de dados nacional que inclui todos os casos de síndrome respiratória aguda grave com necessidade de internação no Brasil. Resultados: Foram identificadas 288 internações (51,3% mulheres) com mediana de idade de 3 anos (intervalo interquartil 0-12 anos). Destes, 38,9% tinham condições médicas crônicas, 55,6% necessitavam de alguma forma de oxigênio suplementar e 30,2% necessitavam de cuidados intensivos. Ocorreram 17 óbitos (5,9%) relacionados à covid-19. Idade inferior a 30 dias foi significativamente associada com aumento da probabilidade de doença crítica (OR 9,52, IC 95% [3,01-30,08]), bem como a presença de uma condição crônica (OR 5,08 IC 95% [2,78-9,33]) ou duas ou mais condições crônicas (OR 6,60, IC 95% [3,17-13,74]). Conclusão: Idade inferior a 30 dias e a presença de doenças crônicas estão fortemente associadas a piores desfechos em crianças brasileiras com infecção por Sars-CoV-2. Essas descobertas podem ajudar as autoridades locais de saúde pública a desenvolver políticas específicas para proteger esse grupo mais vulnerável de crianças.Introduction: There are few data in the literature about the involvement of the pediatric population by COVID-19, especially in developing coutries. Objectives: To describe the epidemiological characteristics and clinical evolution of children hospitalised with COVID-19 as well as identifying the risk factors for severe disease. Methods: Were analysed all hospital admissions of pediatric patients occurred between March and December 2020 in the southern Brazil region with positive RT-PCR for SARS-CoV-2. Data were extracted from a national database that includes all cases of severe acute respiratory syndrome requiring hospitalization in Brazil. Results: We identified 288 hospitalizations (51.3% female) with a median age of 3 years (interquartile range 0-12 years). Of these, 38.9% had chronic medical conditions, 55.6% required some form of supplementary oxygen, and 30.2% required intensive care. There were 17 deaths (5.9%) related to COVID-19. Age less than 30 days was significantly associated with increased odds of critical illness (OR 9.52, 95% CI [3.01-30.08]), as well as the presence of one chronic condition (OR 5.08 95%CI [2.78-9.33]) or two or more chronic conditions (OR 6.60, 95% CI [3.17-13.74]). Conclusion: Age under 30 days old and the presence of chronic conditions are strongly associated with worse outcomes in Brazilian children with Sars-CoV-2 infection. These findings could help the local public health authorities to develop specific policy to protect this more vulnerable group of children

Risk factors for severe COVID-19 infection in Brazilian children

The aim of this study was to describe the epidemiological characteristics and clinical outcome of children hospitalized with COVID-19 and identify the risk factors for severe disease. All hospital admissions of pediatric patients between March and December 2020 in the southern region of Brazil were reviewed and the patients positive for RT-PCR for SARS-CoV-2 were identified. This region encompasses a population of over 2.8 million children and adolescents. Data were extracted from a national database that includes all cases of severe acute respiratory syndrome requiring hospitalization in Brazil. A total of 288 hospitalizations (51.3% female) with a median age of 3 years (interquartile range 0-12 years) were identified. Of these, 38.9% had chronic medical conditions, 55.6% required some form of supplementary oxygen, and 30.2% were admitted to an intensive care unit. There were 17 deaths (5.9%) related to COVID-19. Age less than 30 days was significantly associated with increased odds of critical illness (OR 9.52, 95% CI 3.01-30.08), as well as the presence of one chronic condition (OR 5.08 95% CI 2.78-9.33) or two or more chronic conditions (OR 6.60, 95% CI 3.17-13.74). Conclusion: Age under 30 days old and presence of chronic conditions were strongly associated with unfavorable outcomes in Brazilian children with SARS-CoV-2 infection. These findings could help local public health authorities to develop specific policies to protect this more vulnerable group of children