Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data
Introduction. Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care units (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive adm...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | International Journal of Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2020/9680905 |
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| author | Rohit S. Loomba Enrique G. Villarreal Juan S. Farias Ronald A. Bronicki Saul Flores |
| author_facet | Rohit S. Loomba Enrique G. Villarreal Juan S. Farias Ronald A. Bronicki Saul Flores |
| author_sort | Rohit S. Loomba |
| collection | DOAJ |
| description | Introduction. Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care units (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive admissions (CPAs) in the United States and to determine factors that may impact those admissions. Materials and Methods. This is a retrospective cohort study using data from the COVID-19 Virtual Pediatric System (VPS) dashboard containing information regarding respiratory support and comorbidities for all CPAs between March and April 2020. The state-level data contained 13 different factors from population density, comorbid conditions, and social distancing score. The absolute CPA count was converted to frequency using the state’s population. Univariate and multivariate regression analyses were performed to assess the association between CPA frequency and admission endpoints. Results. A total of 205 CPAs were reported by 167 PICUs across 48 states. The estimated CPA frequency was 2.8 per million children in a one-month period. A total of 3,235 tests were conducted of which 6.3% were positive. Children above 11 years of age comprised 69.7% of the total cohort and 35.1% had moderated or severe comorbidities. The median duration of a CPA was 4.9 days (1.25–12.00 days). Out of the 1,132 total CPA days, 592 (52.2%) involved mechanical ventilation. The inpatient mortalities were 3 (1.4%). Multivariate analyses demonstrated an association between CPAs with greater population density (beta coefficient 0.01, p<0.01). Multivariate analyses also demonstrated an association between pediatric type 1 diabetes mellitus with increased CPA duration requiring advanced respiratory support (beta coefficient 5.1, p<0.01) and intubation (beta coefficient 4.6, p<0.01). Conclusions. Inpatient mortality during PICU CPAs is relatively low at 1.4%. CPA frequency seems to be impacted by population density. Type 1 DM appears to be associated with increased duration of HFNC and intubation. These factors should be included in future studies using patient-level data. |
| format | Article |
| id | doaj-art-527f7bc8afe140bd957d80886b6671f0 |
| institution | Kabale University |
| issn | 1687-9740 1687-9759 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Pediatrics |
| spelling | doaj-art-527f7bc8afe140bd957d80886b6671f02025-02-03T06:43:41ZengWileyInternational Journal of Pediatrics1687-97401687-97592020-01-01202010.1155/2020/96809059680905Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level DataRohit S. Loomba0Enrique G. Villarreal1Juan S. Farias2Ronald A. Bronicki3Saul Flores4Division of Pediatric Cardiac Critical Care, Advocate Children’s Hospital, Chicago, IL, USATecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, MexicoTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, MexicoSections of Critical Care Medicine and Cardiology, Texas Children’s Hospital, Houston, TX, USASections of Critical Care Medicine and Cardiology, Texas Children’s Hospital, Houston, TX, USAIntroduction. Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care units (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive admissions (CPAs) in the United States and to determine factors that may impact those admissions. Materials and Methods. This is a retrospective cohort study using data from the COVID-19 Virtual Pediatric System (VPS) dashboard containing information regarding respiratory support and comorbidities for all CPAs between March and April 2020. The state-level data contained 13 different factors from population density, comorbid conditions, and social distancing score. The absolute CPA count was converted to frequency using the state’s population. Univariate and multivariate regression analyses were performed to assess the association between CPA frequency and admission endpoints. Results. A total of 205 CPAs were reported by 167 PICUs across 48 states. The estimated CPA frequency was 2.8 per million children in a one-month period. A total of 3,235 tests were conducted of which 6.3% were positive. Children above 11 years of age comprised 69.7% of the total cohort and 35.1% had moderated or severe comorbidities. The median duration of a CPA was 4.9 days (1.25–12.00 days). Out of the 1,132 total CPA days, 592 (52.2%) involved mechanical ventilation. The inpatient mortalities were 3 (1.4%). Multivariate analyses demonstrated an association between CPAs with greater population density (beta coefficient 0.01, p<0.01). Multivariate analyses also demonstrated an association between pediatric type 1 diabetes mellitus with increased CPA duration requiring advanced respiratory support (beta coefficient 5.1, p<0.01) and intubation (beta coefficient 4.6, p<0.01). Conclusions. Inpatient mortality during PICU CPAs is relatively low at 1.4%. CPA frequency seems to be impacted by population density. Type 1 DM appears to be associated with increased duration of HFNC and intubation. These factors should be included in future studies using patient-level data.http://dx.doi.org/10.1155/2020/9680905 |
| spellingShingle | Rohit S. Loomba Enrique G. Villarreal Juan S. Farias Ronald A. Bronicki Saul Flores Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data International Journal of Pediatrics |
| title | Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data |
| title_full | Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data |
| title_fullStr | Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data |
| title_full_unstemmed | Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data |
| title_short | Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data |
| title_sort | pediatric intensive care unit admissions for covid 19 insights using state level data |
| url | http://dx.doi.org/10.1155/2020/9680905 |
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