Predictors of mortality in critically ill children hospitalized with laboratory- confirmed COVID-19 pneumonia

Abstract

Abstract Background Children with COVID-19 infection had fewer severe symptoms, which made it challenging to publish clinical data for this age group. This study aimed to determine the clinical features, laboratory markers, and predictors of mortality in children hospitalized in Pediatric Critical Care Units with COVID-19 pneumonia. Methods This retrospective research included all children between the age of ≥ 1 month and 18 years with laboratory-confirmed COVID-19 pneumonia through reverse transcriptase polymerase chain reaction (RT-PCR) from nasopharyngeal swabs who were admitted to Pediatric Critical Care Units between January 2022 and December 2022. Results The study included 62 patients with confirmed COVID-19 infection. Out of the 62 patients, 43 (69.4%) survived and 19 (30.6%) succumbed. High-grade fever, cough, altered level of consciousness, convulsion, CO-RADS IV, elevated blood CRP, urea, D-dimer, ferritin, and sodium were linked to significantly higher mortality risk. (OR: 15.867, p = 0.001, OR: 1.543, p = 0.044, OR: 7.321, p = 0.026, OR: 15.00, p = 0.017, OR: 10.833, p = 0.001, OR: 1.015, p = 0.032, OR: 1.028, p = 0.040, OR: 3.315, p < 0.0001, OR: 1.004, p = 0.049, OR: 1.111, p = 0.006 respectively). Conclusion Our study revealed high in-hospital mortality among critically ill children with confirmed COVID-19 pneumonia. Identification of critically ill children with risk factors for death, such as high-grade fever, cough, altered consciousness, convulsion, CO-RADS IV and V, and raised inflammatory markers at the time of admission could minimize excess mortality during COVID-19 waves.