Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast China

AimTo describe the characteristics of severe and critically ill children with first-wave SARS-CoV-2 Omicron infection admitted to the pediatric intensive care unit (PICU) at the National Children’s Regional Medical Center in Northeast China and to explore factors associated with poor outcomes.Method...

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Main Authors: Tingting Sun, Yunhan He, Zeyu Wang, Lijie Wang, Chunfeng Liu, Wei Xu, Kai You
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1495783/full
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author Tingting Sun
Yunhan He
Zeyu Wang
Lijie Wang
Chunfeng Liu
Wei Xu
Kai You
author_facet Tingting Sun
Yunhan He
Zeyu Wang
Lijie Wang
Chunfeng Liu
Wei Xu
Kai You
author_sort Tingting Sun
collection DOAJ
description AimTo describe the characteristics of severe and critically ill children with first-wave SARS-CoV-2 Omicron infection admitted to the pediatric intensive care unit (PICU) at the National Children’s Regional Medical Center in Northeast China and to explore factors associated with poor outcomes.MethodsThis observational cohort study was conducted in a PICU in northeastern China and included children under 18 years of age who were severely and critically ill due to SARS-CoV-2 Omicron infection between December 2022 and February 2023. Patients were categorized into two groups: the invasive mechanical ventilation (IMV) group and the non-IMV group. The primary outcome measured was the need for IMV, while secondary outcomes included death or prolonged PICU stay. Univariate and multivariate logistic regression analyses were performed to identify risk factors for poor outcomes.ResultsA total of 38 severe and critically ill children were included in the study. Of these, 25 (66%) were diagnosed with respiratory failure, and four (16%) developed acute respiratory distress syndrome. Additionally, 21 (55%) were diagnosed with COVID-19-associated neurological disorders, and 18 (47%) received IMV. Multivariate logistic regression analysis identified the chest computed tomography (CT) score, based on the COVID-19 Risk Assessment and Diagnosis System (CO-RADS), was statistically significant as an independent predictor for IMV in severe and critically ill children (odds ratio [OR]: 2.781 [95% confidence interval (CI): 1.021–7.571]). Furthermore, the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score and serum aspartate aminotransferase (AST) levels at admission were found to be independent predictors of death or prolonged PICU stay.ConclusionsRespiratory failure and COVID-19-associated neurological disorders were the most common complications among severe and critically ill children with first-wave SARS-CoV-2 Omicron infection. Chest CT score, PELOD-2 score, and serum AST levels may serve as important indicators of poor outcomes in this patient population.
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spelling doaj-art-6f8e96cfe41f4fe7bfca6d5aae9886102025-08-20T02:12:19ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-04-011510.3389/fcimb.2025.14957831495783Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast ChinaTingting SunYunhan HeZeyu WangLijie WangChunfeng LiuWei XuKai YouAimTo describe the characteristics of severe and critically ill children with first-wave SARS-CoV-2 Omicron infection admitted to the pediatric intensive care unit (PICU) at the National Children’s Regional Medical Center in Northeast China and to explore factors associated with poor outcomes.MethodsThis observational cohort study was conducted in a PICU in northeastern China and included children under 18 years of age who were severely and critically ill due to SARS-CoV-2 Omicron infection between December 2022 and February 2023. Patients were categorized into two groups: the invasive mechanical ventilation (IMV) group and the non-IMV group. The primary outcome measured was the need for IMV, while secondary outcomes included death or prolonged PICU stay. Univariate and multivariate logistic regression analyses were performed to identify risk factors for poor outcomes.ResultsA total of 38 severe and critically ill children were included in the study. Of these, 25 (66%) were diagnosed with respiratory failure, and four (16%) developed acute respiratory distress syndrome. Additionally, 21 (55%) were diagnosed with COVID-19-associated neurological disorders, and 18 (47%) received IMV. Multivariate logistic regression analysis identified the chest computed tomography (CT) score, based on the COVID-19 Risk Assessment and Diagnosis System (CO-RADS), was statistically significant as an independent predictor for IMV in severe and critically ill children (odds ratio [OR]: 2.781 [95% confidence interval (CI): 1.021–7.571]). Furthermore, the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score and serum aspartate aminotransferase (AST) levels at admission were found to be independent predictors of death or prolonged PICU stay.ConclusionsRespiratory failure and COVID-19-associated neurological disorders were the most common complications among severe and critically ill children with first-wave SARS-CoV-2 Omicron infection. Chest CT score, PELOD-2 score, and serum AST levels may serve as important indicators of poor outcomes in this patient population.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1495783/fullCOVID-19Omicron variantPICUrespiratory failureneurological disorder
spellingShingle Tingting Sun
Yunhan He
Zeyu Wang
Lijie Wang
Chunfeng Liu
Wei Xu
Kai You
Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast China
Frontiers in Cellular and Infection Microbiology
COVID-19
Omicron variant
PICU
respiratory failure
neurological disorder
title Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast China
title_full Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast China
title_fullStr Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast China
title_full_unstemmed Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast China
title_short Characteristics and outcomes in severe and critically ill children with first wave SARS-CoV-2 Omicron infection in Northeast China
title_sort characteristics and outcomes in severe and critically ill children with first wave sars cov 2 omicron infection in northeast china
topic COVID-19
Omicron variant
PICU
respiratory failure
neurological disorder
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1495783/full
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