da JAMA PEDIATRICS
CORONA VIRUS E BAMBINI
Caratteristiche ed esiti dei bambini con
infezione da coronavirus 2019 (COVID-19) Infezione ricoverata in
unità di terapia intensiva pediatrica statunitensi e canadesi
IMPORTANCE The recent and ongoing coronavirus disease 2019 (COVID-19) pandemic has
taken an unprecedented toll on adults critically ill with COVID-19 infection. While there is
evidence that the burden of COVID-19 infection in hospitalized children is lesser than in their
adult counterparts, to date, there are only limited reports describing COVID-19 in pediatric
intensive care units (PICUs).
OBJECTIVE To provide an early description and characterization of COVID-19 infection in
North American PICUs, focusing on mode of presentation, presence of comorbidities,
severity of disease, therapeutic interventions, clinical trajectory, and early outcomes.
DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included children positive for
COVID-19 admitted to 46 North American PICUs between March 14 and April 3, 2020. with
follow-up to April 10, 2020.
MAIN OUTCOMES AND MEASURES Prehospital characteristics, clinical trajectory, and hospital
outcomes of children admitted to PICUs with confirmed COVID-19 infection.
RESULTS Of the 48 children with COVID-19 admitted to participating PICUs, 25 (52%) were
male, and the median (range) age was 13 (4.2-16.6) years. Forty patients (83%) had significant
preexisting comorbidities; 35 (73%) presented with respiratory symptoms and 18 (38%)
required invasive ventilation. Eleven patients (23%) had failure of 2 or more organ systems.
Extracorporeal membrane oxygenation was required for 1 patient (2%). Targeted therapies
were used in 28 patients (61%), with hydroxychloroquine being the most commonly used
agent either alone (11 patients) or in combination (10 patients). At the completion of the
follow-up period, 2 patients (4%) had died and 15 (31%) were still hospitalized, with 3 still
requiring ventilatory support and 1 receiving extracorporeal membrane oxygenation. The
median (range) PICU and hospital lengths of stay for those who had been discharged were 5
(3-9) days and 7 (4-13) days, respectively.
CONCLUSIONS AND RELEVANCE This early report describes the burden of COVID-19 infection
in North American PICUs and confirms that severe illness in children is significant but far less
frequent than in adults. Prehospital comorbidities appear to be an important factor in
children. These preliminary observations provide an important platform for larger and more
extensive studies of children with COVID-19 infection.
Author Affiliations: Author
affiliations are listed at the end of this
article.
Group Information: Members of the
International COVID-19 PICU
Collaborative appear at the end of the
article.
Corresponding Author: Lara S.
Shekerdemian, MD, MHA, Texas
Children’s Hospital, Baylor College of
Medicine, 6651 Main St, Houston, TX
77030 (lssheker@
texaschildrens.org).
Research
JAMAPediatrics | Original Investigation | CARING FOR THE CRITICALLY ILL
JAMA Pediatr. doi:10.1001/jamapediatrics.2020.1948
Published online May 11, 2020
© 2020 American Medical Association. All rights reserved.
