Case Series; Cross-Sectional
Study population and setting
This study included 48 children (median age 13 years, 52% male) with laboratory-confirmed COVID-19 admitted to pediatric intensive care units (PICUs) in 14 U.S. hospitals (out of 46 collaborating PICUs in North America) between March 14 and April 3, 2020. Outcomes were ascertained through April 10, 2020.
Summary of Main Findings
35 children (73%) presented with respiratory symptoms. 40 children (83%) had at least one significant underlying medical condition. At admission, 69% of the pediatric patients were determined to have severe or critical illness. 18 patients (38%) required mechanical ventilation, and 21 (44%) required non-invasive respiratory support. Of the 18 patients who required mechanical ventilation, by the end of follow-up, 2 died (4.2% of all patients), 3 remained on mechanical ventilation, 7 others remained hospitalized, and 6 were discharged alive. Among all patients who died or were discharged, the median hospital stay was 7 days, and the median ICU stay was 5 days.
The study drew from a large group of institutions throughout North America.
Few patients were included in the study, a reflection of the apparently lower likelihood of severe disease in pediatric COVID-19. Follow-up duration was short; the fatality ratio may change with time. Inadequate testing in North America may have resulted in missed COVID-19 diagnoses among hospitalized children.
This is the largest study to date of severe pediatric COVID-19 in the North America.