Factors associated with moderate and severe COVID-19 in pediatric patients
Keywords:
COVID-19, disease severity index, epidemiology, SARS-CoV-2.Abstract
Introduction: The prevalence of COVID-19 in minors exceeds 20 % in Latin America and has shown increases with the variants of the disease. Its presence in this population is characterized by a higher incidence of complications. Given this, the determinants that increase the probability of mild or asymptomatic cases progressing to moderate or severe cases have not been identified.
Objective: To identify the factors associated with moderate and severe COVID-19 in pediatric patients.
Methods: Cross-sectional analytical study. The data of 2,232 patients under 18 years of age confirmed with COVID-19, registered in the epidemiological surveillance system of the city of Trujillo, Peru, during 2020 and 2021, were evaluated. The groups of patients with mild and asymptomatic COVID-19 were compared with those with moderate and severe cases. The factors evaluated corresponded to the indicators present in the epidemiological record of the Peruvian Ministry of Health. The association was determined by logistic regression.
Results: 5.82 % had moderate and severe COVID-19. Adjusted analysis showed that having cardiovascular disease (p= 0.029; ORa: 7.64), chronic neurological disease (p< 0.001; ORa: 12.76), lung disease (p= 0.001; ORa: 11.12), obesity (p= 0.005; ORa: 7.89) and hematological disease (p< 0.001; ORa: 17.70) increase the probability of moderate and severe COVID-19.
Conclusions: Cardiovascular disease, chronic neurological disease, respiratory disease, obesity and hematological disease are associated with moderate and severe COVID-19 in pediatric patients.
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References
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27. Camacho K, Ramírez D, Alonso L, La Rosa D. Revisión bibliográfica sobre la COVID 19 en pacientes con cáncer de pulmón [Internet]. Rev Med Elect. 2021 [acceso: 08/08/2024]; 43(1):12-9. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1684-18242021000102942&lng=es&nrm=iso&tlng=es
28. Keat S, Goh AS, Goh CCY, Tan HS, Ong TC, Tan SM, Low PL, et al. Risk Factors and Outcome of COVID-19 Infection in Haematological Patients: A Multicenter Retrospective Analysis in Malaysia [Internet]. Blood. 2022; 15(140):13232-3. DOI: 10.1182%2Fblood-2022-165307
29. Kosmeri C, Koumpis E, Tsabouri S, Siomou E, Makis A. Hematological manifestations of SARS-CoV-2 in children [Internet]. Pediatr Blood Cancer. 2020; 67(12):e28745. DOI: 10.1002/pbc.28745
30. Nash D, Qasmieh S, Robertson M, Rane M, Zimba R, Kulkarni SG, et al. Household factors and the risk of severe COVID-like illness early in the U.S. pandemic [Internet]. PLoS ONE. 2022; 17(7):e0271786. DOI: 10.1371/journal.pone.0271786
2. Karim SSA, Karim QA. Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic [Internet]. Lancet. 2021; 398(10317):2126-8. DOI: 10.1016/s0140-6736(21)02758-6
3. Hallal PC, Hartwig FP, Horta BL, Silveira MF, Struchiner CJ, Vidaletti LP, et al. SARS-CoV-2 antibody prevalence in Brazil: results from two successive nationwide serological household surveys [Internet]. Lancet Glob Health. 2020, 8(1):e1390-8. DOI: 10.1016/S2214-109X(20)30387-9
4. Aballay L, Coquet J, Scruzzi G, Haluszka E, Franchini G, Carreño P. Estudio de base poblacional de seroprevalencia y factores asociados a la infección por SARS-CoV-2 en Córdoba, Argentina [Internet]. Cad Saúde Pública. 2022; 38(4):e00219821. DOI: 10.1590/0102-311XES219821
5. Götzinger F, Santiago-García B, Noguera-Julián A, Lanaspa M, Lancella L, Calò Carducci FI, et al. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study [Internet]. Lancet Child Adolesc Health. 2020; 4(9):653-61. DOI: 10.1016/S2352-4642(20)30177-2
6. Peeling RW, Heymann DL, Teo YY, García P. Diagnostics for COVID-19: moving from pandemic response to control [Internet]. Lancet. 2022; 399(10326):757-68. DOI: 10.1016/s0140-6736(21)02346-1
7. Centro Nacional de Epidemiologia, Prevencion y Control de Enfermedades [Internet]. Boletín Epidemiológico Volumen 31-SE. Lima. Ministerio de salud, 2022. [acceso: 08/08/2024]. Disponible en: https://bvs.minsa.gob.pe/local/MINSA/5853.pdf
8. Soto-Cabezas MG, et al. COVID-19 among Amazonian indigenous in Peru: mortality, incidence, and clinical characteristics [Internet]. J Public Health (Oxf). 2022; 44(3):359-65. DOI: 10.1093/pubmed/fdac058
9. Tsankov B, Allaire J, Irvine M, Lopez A, Sauvé L, Vallance B, Jacobson K. Severe COVID-19 Infection and Pediatric Comorbidities: A Systematic Review and Meta-Analysis [Internet]. Int J Infect Dis. 2021; 103(1):246-56. DOI: 10.1016/j.ijid.2020.11.163
10. Seyed Alinaghi S, Karimi A, Barzegary A, Mojdeganlou H, Vahedi F, Seyed Peyman M, et al. COVID-19 mortality in patients with immunodeficiency and its predictors: a systematic review [Internet]. Eur J Med Res. 2022; 27(1):195. DOI: 10.1186/s40001-022-00824-7
11. Chilet C, Vilchez M, Maquera-Afaray J, Mesones B, Alvarez D, Miranda R, et al. Características clínicas de niños con COVID-19 admitidas en un centro terciario de referencia en el Perú [Internet]. Rev Fac Med Hum. 2022; 22(4):765-75. DOI: 10.25176/rfmh.v22i4.5094
12. Wang X, Cheng Z. Cross-Sectional Studies: Strengths, Weaknesses, and Recommendations [Internet]. Chest. 2020; 158(1):65-71. DOI: 10.1016/j.chest.2020.03.012
13. Ministerio de Salud del Perú. Ficha de investigación clínico epidemiológica de COVID 19. Centro Nacional de Epidemiología, Prevención y Control de Enfermedades [Internet]. [acceso: 08/08/2024]. Disponible en: https://www.hdhuacho.gob.pe/WEB/descargas_epi/ficha/FI039.pdf
14. Asociación Médica Mundial (AMM). Declaración de Helsinki de La Asociación Médica Mundial. Principios éticos para las investigaciones médicas en seres humanos [Internet]. 2013. [acceso: 08/08/2024]. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/
15. Society of Pediatrics, Chinese Medical Association; Editorial Board, Chinese Journal of Pediatrics. Recommendations for the diagnosis, prevention, and control of the 2019 novel coronavirus infection in children [Internet]. Zhonghua Er Ke Za Zhi. 2020; 58(1):169-74. DOI: 10.3760/cma.j.issn.0578-1310.2020.0004
16. Martínez-Valdez L, Richardson V, Castro-Ceronio LE, et al. Risk factors for COVID-19 hospitalisations and deaths in Mexican children and adolescents: retrospective cross-sectional study [Internet]. BMJ Open. 2022; 12:e055074. DOI: 10.1136/bmjopen-2021-055074
17. Armann J, Doenhardt M, Hufnagel M, Diffloth N, Reichert F, Haas W, et al. Risk factors for hospitalization, disease severity and mortality in children and adolescents with COVID-19: Results from a nationwide German registry [Internet]. MedRxiv Preprint. 2021; 13(21):1-23. DOI: 10.1101/2021.06.07.21258488
18. Antoon JW, Grijalva CG, Thurm C, Richardson T, Spaulding AB, Teufel RJ, et al. Factors Associated With COVID-19 Disease Severity in US Children and Adolescents [Internet]. J Hosp Med. 2021; 16(10):603-10. DOI: 10.12788/jhm.3689
19. Parri N, Magistà A, Marchetti F. Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks [Internet]. Eur J Pediatr. 2020; 179(1):1315-23. DOI: 10.1007/s00431-020-03683-8
20. Vosko I, Zirlik A, Bugger H. Impact of COVID-19 on cardiovascular disease [Internet]. Viruses. 2023; 15(2):508. DOI: 10.3390/v15020508
21. Farrar D, Drouin O, Moore C, Baerg K, Chan K, Cyr C, et al. Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020-May 2021. The lancer Regional Health- Americas [Internet]. 2022; 15(1):100337. DOI: 10.1016/j.lana.2022.100337
22. Antoon JW, Grijalva CG, Thurm C, Richardson T, Spaulding AB, Teufel RJ, et al. Factors Associated With COVID-19 Disease Severity in US Children and Adolescents [Internet]. J Hosp Med. 2021; 16(10):603-10. DOI: 10.12788/jhm.3689
23. Dubé M, Le Coupanec A, Wong AH, Rini JM, Desforges M, Talbot PJ. Axonal transport enables neuron-to-neuron propagation of human coronavirus OC43 [Internet]. J Virol. 2018; 92(1):e00404-18. DOI: 10.1128/jvi.00404-18
24. Lee J, Park S, Jeong H, Ahn J, Choi S, Lee H, Choi B, et al. Immunophenotyping of COVID-19 and influenza highlights the role of type I interferons in development of severe COVID-19 [Internet]. Sci Immunol. 2020; 5(1):eabd1554. DOI: 10.1126/sciimmunol.abd1554
25. Frasca D, Reidy L, Romero M, Diaz A, Cray C, Kahl K. The majority of SARS-CoV-2-specific antibodies in COVID-19 patients with obesity are autoimmune and not neutralizing [Internet]. J Obes. 2022; 46(1):427-32. DOI: 10.1038/s41366-021-01016-9
26. Antonelli M, Penfold R, Merino J, Sudre C, Molteni E, Berry S, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: A prospective, community-based, nested, case-control study [Internet]. Lancet Infect Dis. 2022; 22(1):43-55. DOI: 10.1016/S1473-3099(21)00460-6
27. Camacho K, Ramírez D, Alonso L, La Rosa D. Revisión bibliográfica sobre la COVID 19 en pacientes con cáncer de pulmón [Internet]. Rev Med Elect. 2021 [acceso: 08/08/2024]; 43(1):12-9. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1684-18242021000102942&lng=es&nrm=iso&tlng=es
28. Keat S, Goh AS, Goh CCY, Tan HS, Ong TC, Tan SM, Low PL, et al. Risk Factors and Outcome of COVID-19 Infection in Haematological Patients: A Multicenter Retrospective Analysis in Malaysia [Internet]. Blood. 2022; 15(140):13232-3. DOI: 10.1182%2Fblood-2022-165307
29. Kosmeri C, Koumpis E, Tsabouri S, Siomou E, Makis A. Hematological manifestations of SARS-CoV-2 in children [Internet]. Pediatr Blood Cancer. 2020; 67(12):e28745. DOI: 10.1002/pbc.28745
30. Nash D, Qasmieh S, Robertson M, Rane M, Zimba R, Kulkarni SG, et al. Household factors and the risk of severe COVID-like illness early in the U.S. pandemic [Internet]. PLoS ONE. 2022; 17(7):e0271786. DOI: 10.1371/journal.pone.0271786
Published
2024-09-02
How to Cite
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Ordoñez-Condezo TE, Moquillaza-Alcantara VH. Factors associated with moderate and severe COVID-19 in pediatric patients. Rev Cubana Med Milit [Internet]. 2024 Sep. 2 [cited 2025 Apr. 3];53(3):e024044902. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/44902
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