TY - JOUR
T1 - A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020
AU - Schuster, Jennifer E.
AU - Halasa, Natasha B.
AU - Nakamura, Mari
AU - Levy, Emily R.
AU - Fitzgerald, Julie C.
AU - Young, Cameron C.
AU - Newhams, Margaret M.
AU - Bourgeois, Florence
AU - Staat, Mary A.
AU - Hobbs, Charlotte V.
AU - Dapul, Heda
AU - Feldstein, Leora R.
AU - Jackson, Ashley M.
AU - Mack, Elizabeth H.
AU - Walker, Tracie C.
AU - Maddux, Aline B.
AU - Spinella, Philip C.
AU - Loftis, Laura L.
AU - Kong, Michele
AU - Rowan, Courtney M.
AU - Bembea, Melania M.
AU - Mclaughlin, Gwenn E.
AU - Hall, Mark W.
AU - Babbitt, Christopher J.
AU - Maamari, Mia
AU - Zinter, Matt S.
AU - Cvijanovich, Natalie Z.
AU - Michelson, Kelly N.
AU - Gertz, Shira J.
AU - Carroll, Christopher L.
AU - Thomas, Neal J.
AU - Giuliano, John S.
AU - Singh, Aalok R.
AU - Hymes, Saul R.
AU - Schwarz, Adam J.
AU - Mcguire, John K.
AU - Nofziger, Ryan A.
AU - Flori, Heidi R.
AU - Clouser, Katharine N.
AU - Wellnitz, Kari
AU - Cullimore, Melissa L.
AU - Hume, Janet R.
AU - Patel, Manish
AU - Randolph, Adrienne G.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background: It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered. Methods: Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated. Results: Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI: 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI: 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December). Conclusion: Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies.
AB - Background: It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered. Methods: Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated. Results: Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI: 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI: 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December). Conclusion: Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies.
UR - https://www.scopus.com/pages/publications/85131221725
UR - https://www.scopus.com/pages/publications/85131221725#tab=citedBy
U2 - 10.1093/jpids/piab123
DO - 10.1093/jpids/piab123
M3 - Article
C2 - 35022779
AN - SCOPUS:85131221725
SN - 2048-7193
VL - 11
SP - 191
EP - 198
JO - Journal of the Pediatric Infectious Diseases Society
JF - Journal of the Pediatric Infectious Diseases Society
IS - 5
ER -