The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has collapsed health systems worldwide. In adults, the virus causes severe acute respiratory distress syndrome (ARDS), while in children the disease seems to be milder, although a severe multisystem inflammatory syndrome (MIS-C) has be...

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Bibliographic Details
Published in:BMC infectious diseases 2021-01, Vol.21 (1), p.87-87, Article 87
Main Authors: Girona-Alarcon, Mònica, Bobillo-Perez, Sara, Sole-Ribalta, Anna, Hernandez, Lluisa, Guitart, Carmina, Suarez, Ricardo, Balaguer, Mònica, Cambra, Francisco-Jose, Jordan, Iolanda
Format: Article
Language:English
Subjects:
Acute respiratory distress syndrome
Adrenomedullin
Adult
Adults
Biomarkers
Biomarkers - blood
Brain natriuretic peptide
C-reactive protein
C-Reactive Protein - metabolism
Child
Children
Cohort analysis
Cohort Studies
Coronaviruses
COVID-19
COVID-19 - pathology
Female
Heparin
Hospital patients
Humans
Infections
Infectious diseases
Inflammation
Intensive care units
Male
Mechanical ventilation
Mortality
Multisystem inflammatory syndrome
Natriuretic Peptide, Brain
Peptide Fragments
Populations
Procalcitonin
Procalcitonin - blood
Prospective Studies
Respiration, Artificial
Respiratory diseases
Respiratory distress syndrome
SARS-CoV-2
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
Statistics
Systemic Inflammatory Response Syndrome - pathology
Thromboembolism
Vasoactive agents
Ventilation
Ventilators
Viral diseases
Viruses
Young Adult
Young adults
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Summary:The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has collapsed health systems worldwide. In adults, the virus causes severe acute respiratory distress syndrome (ARDS), while in children the disease seems to be milder, although a severe multisystem inflammatory syndrome (MIS-C) has been described. The aim was to describe and compare the characteristics of the severe COVID-19 disease in adults and children. This prospective observational cohort study included the young adults and children infected with SARS-CoV-2 between March-June 2020 and admitted to the paediatric intensive care unit. The two populations were analysed and compared focusing on their clinical and analytical characteristics and outcomes. Twenty patients were included. There were 16 adults (80%) and 4 children (20%). No mortality was recorded. All the adults were admitted due to ARDS. The median age was 32 years (IQR 23.3-41.5) and the most relevant previous pathology was obesity (n = 7, 43.7%). Thirteen (81.3%) needed mechanical ventilation, with a median PEEP of 13 (IQR 10.5-14.5). Six (37.5%) needed inotropic support due to the sedation. Eight (50%) developed a healthcare-associated infection, the most frequent of which was central line-associated bloodstream infection (n = 7, 71.4%). One patient developed a partial pulmonary thromboembolism, despite him being treated with heparin. All the children were admitted due to MIS-C. Two (50%) required mechanical ventilation. All needed inotropic support, with a median vasoactive-inotropic score of 27.5 (IQR 17.5-30). The difference in the inotropic requirements between the two populations was statistically significant (37.5% vs. 100%, p 
ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-021-05786-5