Severe coronavirus disease pneumonia in pediatric patients in a referral hospital

Ozcan, Serhan; Emeksiz, Serhat; Perk, Oktay; Uyar, Emel; Kanik Yüksek, Saliha

OBJECTIVE: We aimed to evaluate the characteristics and outcomes of critically ill children managed in an intensive care unit because of coronavirus disease (COVID-19) pneumonia with respiratory support requirements. METHODS: We performed a single-center retrospective observational study in a pediatric intensive care unit (PICU) with 32 beds in Ankara City Hospital, Ankara, Turkey, from March 13, 2020, to December 31, 2020. Patients who needed positive-pressure ventilation (PPV) therapy for COVID-19 pneumonia were included in the study. Demographic, clinical, and laboratory data were extracted from the patients’ electronic medical records. As outcomes, the hospitalization rate of all pediatric patients diagnosed as having with COVID-19 by PCR, PICU admission rate for COVID-19 pneumonia among all hospitalized patients, PPV support rate, intensive care hospitalization duration (days), total hospitalization duration (days), survival rate, and tracheotomy requirement were evaluated. RESULTS: During the study period, 7033 children tested positive for COVID-19 in PCR tests. Of these patients, 1219 were hospitalized for COVID-19. Seventeen patients needed PPV support because of COVD-19 pneumonia. High proportion (65%) of patients admitted to the PICU had co-morbid diseases. Noninvasive ventilation was applied in 15 patients (88%). The hospitalization rate among the children with COVID-19 was 17%, of whom 1.6% were admitted to the PICU. Mortality rates were 0.056% of all the cases and 0.32% of the hospitalized patients in our hospital. CONCLUSION: The presence of a co-morbid disease could be a sign of severe disease in children with higher lethality. Very few children required PPV support because of severe COVID-19 pneumonia.