Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure

We report our experience of COVID-19 disease with hypoxemic respiratory failure among patients aged 12–21 years admitted to the intensive care unit at two tertiary care institutions in Northeastern and Midwestern United States. Our results showed that during the main study period that spanned the in...

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Main Authors: Helen Kest, Ashlesha Kaushik, Somia Shaheen, William Debruin, Sahil Zaveri, Mario Colletti, Sandeep Gupta
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2022/7601185
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author Helen Kest
Ashlesha Kaushik
Somia Shaheen
William Debruin
Sahil Zaveri
Mario Colletti
Sandeep Gupta
author_facet Helen Kest
Ashlesha Kaushik
Somia Shaheen
William Debruin
Sahil Zaveri
Mario Colletti
Sandeep Gupta
author_sort Helen Kest
collection DOAJ
description We report our experience of COVID-19 disease with hypoxemic respiratory failure among patients aged 12–21 years admitted to the intensive care unit at two tertiary care institutions in Northeastern and Midwestern United States. Our results showed that during the main study period that spanned the initial surge at both geographic locations, adolescents with SARS-COV-2 infection admitted to the ICU with respiratory failure were more likely to be male, black, and morbidly obese and with two or more comorbidities. The majority (79%) were admitted with COVID-19-related pneumonia and 15 developed respiratory failure; two-thirds of patients with respiratory failure (9/15, 60%) required mechanical ventilation (MV). More than two-thirds of patients (11/15, 75%) with respiratory failure were obese with BMI > 30 compared to those without respiratory failure (p<0.0001), and those with BMI > 40 were 4.3 times more likely to develop respiratory failure than those with normal BMI; 40% of patients with respiratory failure had two or more pre-existing medical comorbidities. Inflammatory markers were 2–20 times higher in patients with respiratory failure (p<0.05). The majority of patients on MV (7/9) developed complications, including ARDS (acute respiratory distress syndrome), acute renal injury, and cerebral anoxic encephalopathy. Patients with respiratory failure had a significantly longer length of hospital stay than patients without respiratory failure (p<0.05). The majority of the admitted adolescents in the ICU received steroid treatment. None of the patients died. An additional review of a 6-month postvaccination approval period indicated that the majority of ICU admissions were unvaccinated, obese, black patients and all patients who developed respiratory failure were unvaccinated. Our study highlights and supports the need for maximizing opportunities to address vaccination and healthcare gaps in adolescents as well as promoting public health measures including correct use of masks, effective vaccination campaigns for this age group, and additional passive preventive interventions for COVID-19 disease in adolescents especially with comorbid conditions, and in minority populations.
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spelling doaj-art-b39227ef7d794a8bb1fddb471a504bc52025-08-20T02:23:26ZengWileyCritical Care Research and Practice2090-13132022-01-01202210.1155/2022/7601185Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory FailureHelen Kest0Ashlesha Kaushik1Somia Shaheen2William Debruin3Sahil Zaveri4Mario Colletti5Sandeep Gupta6Division of Pediatric Infectious DiseasePediatric Infectious DiseasesDepartment of PediatricsPediatric Intensive CareSt. Joseph’s HealthPediatric Intensive CarePulmonary and Critical CareWe report our experience of COVID-19 disease with hypoxemic respiratory failure among patients aged 12–21 years admitted to the intensive care unit at two tertiary care institutions in Northeastern and Midwestern United States. Our results showed that during the main study period that spanned the initial surge at both geographic locations, adolescents with SARS-COV-2 infection admitted to the ICU with respiratory failure were more likely to be male, black, and morbidly obese and with two or more comorbidities. The majority (79%) were admitted with COVID-19-related pneumonia and 15 developed respiratory failure; two-thirds of patients with respiratory failure (9/15, 60%) required mechanical ventilation (MV). More than two-thirds of patients (11/15, 75%) with respiratory failure were obese with BMI > 30 compared to those without respiratory failure (p<0.0001), and those with BMI > 40 were 4.3 times more likely to develop respiratory failure than those with normal BMI; 40% of patients with respiratory failure had two or more pre-existing medical comorbidities. Inflammatory markers were 2–20 times higher in patients with respiratory failure (p<0.05). The majority of patients on MV (7/9) developed complications, including ARDS (acute respiratory distress syndrome), acute renal injury, and cerebral anoxic encephalopathy. Patients with respiratory failure had a significantly longer length of hospital stay than patients without respiratory failure (p<0.05). The majority of the admitted adolescents in the ICU received steroid treatment. None of the patients died. An additional review of a 6-month postvaccination approval period indicated that the majority of ICU admissions were unvaccinated, obese, black patients and all patients who developed respiratory failure were unvaccinated. Our study highlights and supports the need for maximizing opportunities to address vaccination and healthcare gaps in adolescents as well as promoting public health measures including correct use of masks, effective vaccination campaigns for this age group, and additional passive preventive interventions for COVID-19 disease in adolescents especially with comorbid conditions, and in minority populations.http://dx.doi.org/10.1155/2022/7601185
spellingShingle Helen Kest
Ashlesha Kaushik
Somia Shaheen
William Debruin
Sahil Zaveri
Mario Colletti
Sandeep Gupta
Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure
Critical Care Research and Practice
title Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure
title_full Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure
title_fullStr Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure
title_full_unstemmed Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure
title_short Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure
title_sort epidemiologic characteristics of adolescents with covid 19 disease with acute hypoxemic respiratory failure
url http://dx.doi.org/10.1155/2022/7601185
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