A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020.

Abstract

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.

• Authors: Jennifer E Schuster, Natasha B Halasa, Mari Nakamura, Emily R Levy, Julie C Fitzgerald, Cameron C Young, Margaret M Newhams, Florence Bourgeois, Mary A Staat, Charlotte V Hobbs, Heda Dapul, Leora R Feldstein, Ashley M Jackson, Elizabeth H Mack, Tracie C Walker, Aline B Maddux, Philip C Spinella, Laura L Loftis, Michele Kong, Courtney M Rowan, Melania M Bembea, Gwenn E McLaughlin, Mark W Hall, Christopher J Babbitt, Mia Maamari, Matt S Zinter, Natalie Z Cvijanovich, Kelly N Michelson, Shira J Gertz, Christopher L Carroll, Neal J Thomas, John S Giuliano, Aalok R Singh, Saul R Hymes, Adam J Schwarz, John K McGuire, Ryan A Nofziger, Heidi R Flori, Katharine N Clouser, Kari Wellnitz, Melissa L Cullimore, Janet R Hume, Manish Patel, Adrienne G Randolph, Overcoming COVID-19 Investigators
• Journal: Journal of the Pediatric Infectious Diseases Society (J Pediatric Infect Dis Soc) Vol. 11 Issue 5 Pg. 191-198 (May 30 2022) ISSN: 2048-7207 [Electronic] England
• PMID: 35022779 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Child
• Critical Illness
• Hospitalization
• Hospitals, Pediatric
• Humans
• Intensive Care Units
• United States
• COVID-19 Drug Treatment