SARS-CoV-2 with concurrent respiratory viral infection as a risk factor for a higher level of care in hospitalized pediatric patients

Authors

Lea Dikranian, From the Pediatric Emergency Medicine, Division of Emergency Medicine, Childrens Hospital of Michigan, Detroit, MI.
Suzanne Barry, Section of Critical Care Medicine, Department of Pediatrics.Follow
Ashar Ata, Departments of Surgery and Emergency Medicine, Albany Medical Center, Albany, NY.
Katie Chiotos, Division of Critical Care Medicine, Department of Anesthesia and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia PA.Follow
Katja Gist, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
Utpal Bhalala, University of Texas Medical Branch, Driscoll Health System, Corpus Christi, TX.Follow
Valerie Danesh, Baylor Scott & White Health, Dallas, TX.Follow
Smitty Heavner, Department of Medicine, Prisma Health, Greenville, SC.
Varsha Gharpure, Advocate Aurora HealthFollow
Erica C. Bjornstad, Division of Nephrology, Department of Pediatrics, University of Alabama Birmingham, Birmingham, AL.Follow
Olivia Irby, Division of Critical Care Medicine, Department of Pediatrics, Arkansas Childrens Hospital, Little Rock, AK.
Julia A. Heneghan, Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.
Vicki Montgomery, Division of Critical Care Medicine, Department of Pediatrics, University of Louisville and Norton Childrens Hospital, Louisville, KY.
Neha Gupta, Department of Pediatrics, Section of Critical Care Medicine, University of Oklahoma College of Medicine, Oklahoma City, OK.
Aaron Miller, St. Louis University School of Medicine, St. Louis, MO.
Allan Walkey, The Pulmonary Center, Division of Pulmonary, Allergy, Sleep and Critical Care; Department of Medicine; Boston University School of Medicine, Boston, MA.
Sandeep Tripathi, Department of Pediatrics OSF Saint Francis Medical Center/University of Illinois College of Medicine at Peoria, Peoria, IL.
Karen Boman, Division of Nephrology and Hypertension, Department of Medicine; Mayo Clinic, Rochester, MN.Follow
Vikas Bansal, Division of Research, Hospital Corporation of America Healthcare, Nashville, TN.Follow
Vishakha Kumar, Division of Nephrology and Hypertension, Department of Medicine; Mayo Clinic, Rochester, MN.
Rahul Kashyap, Division of Research, Hospital Corporation of America Healthcare, Nashville, TN.
Imran Sayed, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Childrens Hospital Colorado, Aurora, CO.
Christopher Woll, Section of Pediatric Emergency Medicine, Departments of Pediatrics and Emergency Medicine, Albany Medical Center, Albany, NY.

Recommended Citation

Dikranian L, Barry S, Ata A, et al. SARS-CoV-2 With Concurrent Respiratory Viral Infection as a Risk Factor for a Higher Level of Care in Hospitalized Pediatric Patients. Pediatr Emerg Care. 2022;38(9):472-476. doi:10.1097/PEC.0000000000002814

Affiliations

Advocate Children's Hospital

Abstract

Objective: As of early 2021, there have been over 3.5 million pediatric cases of SARS-CoV-2, including 292 pediatric deaths in the United States. Although most pediatric patients present with mild disease, they are still at risk for developing significant morbidity requiring hospitalization and intensive care unit (ICU) level of care. This study was performed to evaluate if the presence of concurrent respiratory viral infections in pediatric patients admitted to the hospital with SARS-CoV-2 was associated with an increased rate of ICU level of care.

Design: A multicenter, international, noninterventional, cross-sectional study using data provided through The Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study database.

Setting: The medical ward and ICU of 67 participating hospitals.

Patients: Pediatric patients younger than 18 years hospitalized with SARS-CoV-2.

Interventions: None.

Measurements and main results: A total of 922 patients were included. Among these patients, 391 required ICU level care and 31 had concurrent non-SARS-CoV-2 viral coinfection. In a multivariate analysis, after accounting for age, positive blood culture, positive sputum culture, preexisting chronic medical conditions, the presence of a viral respiratory coinfection was associated with need for ICU care (odds ratio, 3.6; 95% confidence interval, 1.6-9.4; P < 0.01).

Conclusions: This study demonstrates an association between concurrent SARS-CoV-2 infection with viral respiratory coinfection and the need for ICU care. Further research is needed to identify other risk factors that can be used to derive and validate a risk-stratification tool for disease severity in pediatric patients with SARS-CoV-2.

Document Type

Article

PubMed ID

36040468