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oai:recercat.cat:11351/103922025-10-24T10:29:45Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:29:45Z urn:hdl:11351/10392 Characteristics and management of patients with SARS-CoV2 infection admitted to pediatric intensive care units: Data analysis of the Spanish national multicenter registry Slocker Barrio, Maria Belda Hofheinz, Sylvia Guitart Pardellans, Carmina García-Salido, Alberto De Carlos Vicente, Juan Carlos Cuervas-Mons Tejedor, Maite Roca Pascual, David Pediatria intensiva COVID-19 (Malaltia) - Tractament Registres mèdics DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections Other subheadings::Other subheadings::/therapy HEALTH CARE::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Units::Intensive Care Units::Intensive Care Units, Pediatric DISCIPLINES AND OCCUPATIONS::Natural Science Disciplines::Mathematics::Data Analysis ORGANISMOS::virus::virus ARN::Nidovirales::Coronaviridae::coronavirus::Betacoronavirus::virus del SRAS Otros calificadores::Otros calificadores::/terapia ATENCIÓN DE SALUD::instalaciones, servicios y personal de asistencia sanitaria::centros sanitarios::unidades hospitalarias::unidades de cuidados intensivos::unidades de cuidados intensivos pediátricos DISCIPLINAS Y OCUPACIONES::disciplinas de las ciencias naturales::matemáticas::análisis de datos SARS-COV-2; Mechanical ventilation; Pediatric intensive care SARS-COV-2; Ventilació mecànica; Cures intensives pediàtriques SARS-COV-2; Ventilacion mecanica; Cuidados intensivos pediátricos Introduction The purpose of this study is to describe the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) disease characteristics and management in children admitted to the pediatric intensive care units (PICU). Methods The present study was based on a national multicentric prospective registry including PICU patients with SARS-CoV2 infection or symptoms of multisystem inflammatory syndrome in children (MIS-C). Results A total of 298 patients were admitted to 41 different Spanish PICUs. A total of 76% of them were previously healthy. The most frequent manifestation was MIS-C (69.8%). On admission, 59.4% of patients did not have respiratory distress, and only 17.4% needed conventional mechanical ventilation (MV). The need for MV was associated with age (incidence rate ratios [IRR] 1.21, p < .012), pediatric sequential organ failure assessment score (p-SOFA) Score (IRR 1.12, p = .001), and need for transfusion (IRR 4.5, p < .004) in MIS-C patients, and with vasoactive drug use (IRR 2.73, p = .022) and the diagnosis of acute respiratory distress syndrome (IRR 2.83, p = .018) in patients admitted for other reasons. During the first day of admission, 56% of patients met shock criteria and 50.7% needed vasoactive drugs. In MIS-C patients, their use was associated with higher p-SOFA score (IRR 1.06, p < .001) and with the diagnosis of shock (IRR 5.78, p < .001). In patients without MIS-C, it was associated with higher p-SOFA score (IRR 1.05, p = .022). The mortality rate was 3%, being lower in MIS-C patients compared to patients admitted for other reasons (0.5% vs. 9.4%, p < .001). It was also lower in previously healthy patients compared to patients with previous comorbidities (0.9% vs. 9.7%, p < .001). Conclusions Severe SARS-CoV2 infection is uncommon in the pediatric population. In our series, respiratory distress was rare, being MIS-C the most frequent cause of PICU admission related to SARS-CoV2. In most cases, the course of the disease was mild except in children with previous diseases. This study has been founded by the Carlos III Health Institute (ISCIII) through the COVID-19 found. Ref. COV20-00944. The founder had no role in study design, data collection, analysis and interpretation. 2025-10-24T10:29:45Z 2025-10-24T10:29:45Z 2023-10-02T11:25:05Z 2023-10-02T11:25:05Z 2023-07-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/10392 Pediatric Pulmonology;58(10) https://doi.org/10.1002/ppul.26613 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Wiley Scientia