Retrospective cohort of children and adolescents hospitalized by COVID-19 in Brazil from the beginning of the pandemic to August 1st, 2020.

Gomes, Nivreanes Tcherno Nulle; Haslett, Maria Isabella Claudino; Alves, Ana Julia Silva E; Percio, Jadher; Duarte, Magda Machado Saraiva; Malta, Juliane Maria Alves Siqueira; Carvalho, Felipe Cotrim de; Almeida, Walquiria Aparecida Ferreira de; Gava, Caroline; Souza, Libia Roberta de Oliveira; Fantinato, Francieli Fontana Sutile Tardetti; Santos, Elizabeth David Dos; Silveira, Marysabel Pinto Telis; Possignollo, Jéssica; Miranda, Vanessa Iribarrem Avena; Silveira, Mariângela Freitas da; Pizzol, Tatiane da Silva Dal; Serrate, Sotero; Bertoldi, Andréa Dâmaso

OBJECTIVES To characterize the study population, estimating the in-hospital lethality rate by state and analysing associated factors with COVID-19-related deaths. METHODS A retrospective cohort study was carried out of hospitalised children and adolescents diagnosed with COVID-19, confirmed by RT-PCR, whose outcome was death by COVID-19 or recovery, from 2020 March 1 to August 1. The data source was the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe in Brazilian acronym), where patients with Severe Acute Respiratory Syndrome (SARS) are notified. Children were defined as those between the ages of 0 and 11, and adolescents those between 12 and 18. A bi and multivariate analysis were performed using Poisson Regression with robust variance, with adjusted Relative Risk as the final association measure. RESULTS A total of 4,930 cases were analysed; 2,553 (51.8%) were males, 2,335 (47.4%) were brown-skinned. The Federative Unit of Roraima presented the highest in-hospital case-fatality rate, with 68.8% (11/16). Multivariate analysis showed that belonging to the age group adolescent (RR = 1.59; 95%CI 1.12 - 2.25; p = 0.009), SARS-critical patient (RR = 4.56; 95%CI 2, 77 - 7.51; p < 0.001) and presenting immunological disorders (RR = 2.24; 95%CI 1.58 - 3.17; p < 0.001) as comorbidities were statistically associated factors with death by COVID-19. CONCLUSION It was observed that adolescents, SARS-critical patients, and presence of immunological disorders were important factors associated with death. Active surveillance and differentiated care are recommended for patients with chronic diseases and special immunological conditions.