High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru
Introduction Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We pr...
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| Veröffentlicht in: | Pediatric research 2022-06, Vol.91 (7), p.1730-1734 |
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| creator | Coronado Munoz, Alvaro Tasayco, Jaime Morales, Willy Moreno, Luis Zorrilla, David Stapleton, Angie Pajuelo, Patricia Reyes, Giuliana Estupiñan, Matilde Seminario, Ricardo Ortiz, Manuel Domínguez, Jesús |
| description | Introduction
Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting.
Methods
Prospective case–control study that included patients |
| doi_str_mv | 10.1038/s41390-021-01547-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8090521</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2522191566</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-e06c5100cbb0eab2005e636501f0100056e614fcccd59b672777e3b39b173f293</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS0EIkPgB1ggS2zYNJSf3d4goeGRSJHCAtgat7t6xqGnPdhuSP4ehwnhsWBVUtW5t6p0CXnM4DkD0b3IkgkDDXDWAFOybS7vkBVTorakbO-SFYBgjTCmOyIPcr4AYFJ18j45EsJI1mm-Ip9PwmZLw-zDgLNHGkeaS4pfkLp5oLuYiptCuaoE3eMQXEnBU59CCd5N1LuEdO9KwLlk-j2ULV2ffzp93TBzrXiPaXlI7o1uyvjoph6Tj2_ffFifNGfn707Xr84aL1tZGgTtFQPwfQ_oeg6gUAutgI1Q26A0aiZH7_2gTK9b3rYtil6YnrVi5EYck5cH3_3S73Dw9aLkJrtPYefSlY0u2L8nc9jaTfxmOzCgOKsGz24MUvy6YC52F7LHaXIzxiVbrjhnhimtK_r0H_QiLmmu71muOy25VkZVih8on2LOCcfbYxjY6wDtIUBbA7Q_A7SXVfTkzzduJb8Sq4A4ALmO5g2m37v_Y_sD50ymKQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2686426595</pqid></control><display><type>article</type><title>High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Coronado Munoz, Alvaro ; Tasayco, Jaime ; Morales, Willy ; Moreno, Luis ; Zorrilla, David ; Stapleton, Angie ; Pajuelo, Patricia ; Reyes, Giuliana ; Estupiñan, Matilde ; Seminario, Ricardo ; Ortiz, Manuel ; Domínguez, Jesús</creator><creatorcontrib>Coronado Munoz, Alvaro ; Tasayco, Jaime ; Morales, Willy ; Moreno, Luis ; Zorrilla, David ; Stapleton, Angie ; Pajuelo, Patricia ; Reyes, Giuliana ; Estupiñan, Matilde ; Seminario, Ricardo ; Ortiz, Manuel ; Domínguez, Jesús</creatorcontrib><description>Introduction
Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting.
Methods
Prospective case–control study that included patients <17 years old admitted to a pediatric critical care unit with a positive test confirming COVID-19. The primary outcome was mortality. Fisher’s exact test and the Mann–Whitney
U
test were used for the analysis.
Results
Forty-seven patients were admitted to critical care. The mortality of our study is 21.3%. The mortality of patients with neurological presentation was 45.5%, which was significantly higher than the mortality of acute COVID-19 (26.7%) and MIS-C (4.8%),
p
0.18. Other risk factors for mortality in our cohort were strokes and comorbidities. Only one patient presenting with hemorrhagic stroke had an undiagnosed comorbidity.
Conclusion
Cerebrovascular events associated with COVID-19 in pediatric patients, including infants, must be recognized as one of the more severe presentations of this infection in pediatric patients.
Impact
Pediatric patients with COVID-19 can present with hemorrhagic and ischemic strokes on presentation.
Neurological presentation in pediatric patients with COVID-19 has high mortality.
Mortality of pediatric patients with COVID-19 is associated with comorbidities.
Pediatric presentation and outcomes of COVID-19 in different regions can be novel to previously described.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-021-01547-x</identifier><identifier>PMID: 33941862</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Clinical ; Clinical Research Article ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; Critical Care ; Hemorrhagic Stroke - epidemiology ; Hemorrhagic Stroke - etiology ; Hemorrhagic Stroke - mortality ; Humans ; Incidence ; Infant ; Medicine ; Medicine & Public Health ; Mortality ; Pediatric Surgery ; Pediatrics ; Peru - epidemiology ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; Stroke ; Systemic Inflammatory Response Syndrome</subject><ispartof>Pediatric research, 2022-06, Vol.91 (7), p.1730-1734</ispartof><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021</rights><rights>2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.</rights><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-e06c5100cbb0eab2005e636501f0100056e614fcccd59b672777e3b39b173f293</citedby><cites>FETCH-LOGICAL-c474t-e06c5100cbb0eab2005e636501f0100056e614fcccd59b672777e3b39b173f293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-021-01547-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-021-01547-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33941862$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coronado Munoz, Alvaro</creatorcontrib><creatorcontrib>Tasayco, Jaime</creatorcontrib><creatorcontrib>Morales, Willy</creatorcontrib><creatorcontrib>Moreno, Luis</creatorcontrib><creatorcontrib>Zorrilla, David</creatorcontrib><creatorcontrib>Stapleton, Angie</creatorcontrib><creatorcontrib>Pajuelo, Patricia</creatorcontrib><creatorcontrib>Reyes, Giuliana</creatorcontrib><creatorcontrib>Estupiñan, Matilde</creatorcontrib><creatorcontrib>Seminario, Ricardo</creatorcontrib><creatorcontrib>Ortiz, Manuel</creatorcontrib><creatorcontrib>Domínguez, Jesús</creatorcontrib><title>High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Introduction
Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting.
Methods
Prospective case–control study that included patients <17 years old admitted to a pediatric critical care unit with a positive test confirming COVID-19. The primary outcome was mortality. Fisher’s exact test and the Mann–Whitney
U
test were used for the analysis.
Results
Forty-seven patients were admitted to critical care. The mortality of our study is 21.3%. The mortality of patients with neurological presentation was 45.5%, which was significantly higher than the mortality of acute COVID-19 (26.7%) and MIS-C (4.8%),
p
0.18. Other risk factors for mortality in our cohort were strokes and comorbidities. Only one patient presenting with hemorrhagic stroke had an undiagnosed comorbidity.
Conclusion
Cerebrovascular events associated with COVID-19 in pediatric patients, including infants, must be recognized as one of the more severe presentations of this infection in pediatric patients.
Impact
Pediatric patients with COVID-19 can present with hemorrhagic and ischemic strokes on presentation.
Neurological presentation in pediatric patients with COVID-19 has high mortality.
Mortality of pediatric patients with COVID-19 is associated with comorbidities.
Pediatric presentation and outcomes of COVID-19 in different regions can be novel to previously described.</description><subject>Adolescent</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical</subject><subject>Clinical Research Article</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>Critical Care</subject><subject>Hemorrhagic Stroke - epidemiology</subject><subject>Hemorrhagic Stroke - etiology</subject><subject>Hemorrhagic Stroke - mortality</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Peru - epidemiology</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>SARS-CoV-2</subject><subject>Stroke</subject><subject>Systemic Inflammatory Response Syndrome</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kctuFDEQRS0EIkPgB1ggS2zYNJSf3d4goeGRSJHCAtgat7t6xqGnPdhuSP4ehwnhsWBVUtW5t6p0CXnM4DkD0b3IkgkDDXDWAFOybS7vkBVTorakbO-SFYBgjTCmOyIPcr4AYFJ18j45EsJI1mm-Ip9PwmZLw-zDgLNHGkeaS4pfkLp5oLuYiptCuaoE3eMQXEnBU59CCd5N1LuEdO9KwLlk-j2ULV2ffzp93TBzrXiPaXlI7o1uyvjoph6Tj2_ffFifNGfn707Xr84aL1tZGgTtFQPwfQ_oeg6gUAutgI1Q26A0aiZH7_2gTK9b3rYtil6YnrVi5EYck5cH3_3S73Dw9aLkJrtPYefSlY0u2L8nc9jaTfxmOzCgOKsGz24MUvy6YC52F7LHaXIzxiVbrjhnhimtK_r0H_QiLmmu71muOy25VkZVih8on2LOCcfbYxjY6wDtIUBbA7Q_A7SXVfTkzzduJb8Sq4A4ALmO5g2m37v_Y_sD50ymKQ</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Coronado Munoz, Alvaro</creator><creator>Tasayco, Jaime</creator><creator>Morales, Willy</creator><creator>Moreno, Luis</creator><creator>Zorrilla, David</creator><creator>Stapleton, Angie</creator><creator>Pajuelo, Patricia</creator><creator>Reyes, Giuliana</creator><creator>Estupiñan, Matilde</creator><creator>Seminario, Ricardo</creator><creator>Ortiz, Manuel</creator><creator>Domínguez, Jesús</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220601</creationdate><title>High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru</title><author>Coronado Munoz, Alvaro ; Tasayco, Jaime ; Morales, Willy ; Moreno, Luis ; Zorrilla, David ; Stapleton, Angie ; Pajuelo, Patricia ; Reyes, Giuliana ; Estupiñan, Matilde ; Seminario, Ricardo ; Ortiz, Manuel ; Domínguez, Jesús</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-e06c5100cbb0eab2005e636501f0100056e614fcccd59b672777e3b39b173f293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical</topic><topic>Clinical Research Article</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>Critical Care</topic><topic>Hemorrhagic Stroke - epidemiology</topic><topic>Hemorrhagic Stroke - etiology</topic><topic>Hemorrhagic Stroke - mortality</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Peru - epidemiology</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>SARS-CoV-2</topic><topic>Stroke</topic><topic>Systemic Inflammatory Response Syndrome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coronado Munoz, Alvaro</creatorcontrib><creatorcontrib>Tasayco, Jaime</creatorcontrib><creatorcontrib>Morales, Willy</creatorcontrib><creatorcontrib>Moreno, Luis</creatorcontrib><creatorcontrib>Zorrilla, David</creatorcontrib><creatorcontrib>Stapleton, Angie</creatorcontrib><creatorcontrib>Pajuelo, Patricia</creatorcontrib><creatorcontrib>Reyes, Giuliana</creatorcontrib><creatorcontrib>Estupiñan, Matilde</creatorcontrib><creatorcontrib>Seminario, Ricardo</creatorcontrib><creatorcontrib>Ortiz, Manuel</creatorcontrib><creatorcontrib>Domínguez, Jesús</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coronado Munoz, Alvaro</au><au>Tasayco, Jaime</au><au>Morales, Willy</au><au>Moreno, Luis</au><au>Zorrilla, David</au><au>Stapleton, Angie</au><au>Pajuelo, Patricia</au><au>Reyes, Giuliana</au><au>Estupiñan, Matilde</au><au>Seminario, Ricardo</au><au>Ortiz, Manuel</au><au>Domínguez, Jesús</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>91</volume><issue>7</issue><spage>1730</spage><epage>1734</epage><pages>1730-1734</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Introduction
Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting.
Methods
Prospective case–control study that included patients <17 years old admitted to a pediatric critical care unit with a positive test confirming COVID-19. The primary outcome was mortality. Fisher’s exact test and the Mann–Whitney
U
test were used for the analysis.
Results
Forty-seven patients were admitted to critical care. The mortality of our study is 21.3%. The mortality of patients with neurological presentation was 45.5%, which was significantly higher than the mortality of acute COVID-19 (26.7%) and MIS-C (4.8%),
p
0.18. Other risk factors for mortality in our cohort were strokes and comorbidities. Only one patient presenting with hemorrhagic stroke had an undiagnosed comorbidity.
Conclusion
Cerebrovascular events associated with COVID-19 in pediatric patients, including infants, must be recognized as one of the more severe presentations of this infection in pediatric patients.
Impact
Pediatric patients with COVID-19 can present with hemorrhagic and ischemic strokes on presentation.
Neurological presentation in pediatric patients with COVID-19 has high mortality.
Mortality of pediatric patients with COVID-19 is associated with comorbidities.
Pediatric presentation and outcomes of COVID-19 in different regions can be novel to previously described.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>33941862</pmid><doi>10.1038/s41390-021-01547-x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Pediatric research, 2022-06, Vol.91 (7), p.1730-1734 |
| issn | 0031-3998 1530-0447 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Case-Control Studies Child Child, Preschool Clinical Clinical Research Article Coronaviruses COVID-19 COVID-19 - complications Critical Care Hemorrhagic Stroke - epidemiology Hemorrhagic Stroke - etiology Hemorrhagic Stroke - mortality Humans Incidence Infant Medicine Medicine & Public Health Mortality Pediatric Surgery Pediatrics Peru - epidemiology Prospective Studies Risk Factors SARS-CoV-2 Stroke Systemic Inflammatory Response Syndrome |
| title | High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru |
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