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High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru

2021; Springer Nature; Volume: 91; Issue: 7 Linguagem: Inglês

10.1038/s41390-021-01547-x

1530-0447

Álvaro Coronado Muñoz, Jaime Tasayco, Willy Morales, Luis Manuel Pulido Moreno, David Martínez Zorrilla, Angie Stapleton, Patricia Alonso Pajuelo, Giuliana Reyes, Matilde Estupiñan-Vigil, Ricardo Seminario, Manuel S. Ortíz, R. Domínguez,

Kawasaki Disease and Coronary Complications

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.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.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.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.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.