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Predictors of mortality in children admitted with SARS‐CoV‐2 infection to a tertiary care hospital in North India
Author(s) -
Sharma Ankita G,
Kumar Virendra,
Sodani Ravitanaya,
Sapre Anuja,
Singh Preeti,
Saha Abhijeet,
Sharma Suvasini,
Ray Sandip,
Pemde Harish
Publication year - 2022
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.15737
Subject(s) - medicine , acute kidney injury , pediatrics , retrospective cohort study , sepsis , myocarditis , ards , odds ratio , lung
Aim To compare the demographic, clinical, laboratory and radiological parameters of patients with different clinical outcomes (death or discharge) and analyse them to find out the potential predictors for mortality in children hospitalised with SARS‐CoV‐2 infection. Methods Retrospective chart review of all patients less than 18 years of age with laboratory‐confirmed SARS‐CoV‐2 infection and requiring hospital admission between 16 April 2020 and 31 October 2020. Results Of 255 children with SARS‐CoV‐2 infection, 100 patients (median age 62.5 months, 59% males, 70% with moderate to severe disease) were hospitalised, of whom 27 died (median age 72 months, 59% males and 30% severely underweight). The subgroup with comorbidities ( n = 14) was older (median age 126 months) and had longer duration of stay (median 10 days). Fever and respiratory symptoms were comparable while gastrointestinal symptoms were more common among non‐survivors. Hypoxia at admission (odds ratio (OR) 5.48, P = 0.001), multiorgan dysfunction (OR 75.42, P = 0.001), presence of acute kidney injury (OR 11.66, P = 0.001), thrombocytopenia (OR 4.40, P = 0.003) and raised serum C‐reactive protein (CRP) (OR 4.69, P = 0.02) were independently associated with mortality. The median time from hospitalisation to death was 3 days. The deceased group had significantly higher median levels of inflammatory parameters and a higher incidence of complications (myocarditis, encephalitis, acute respiratory distress syndrome and shock). Conclusions Hypoxia at admission, involvement of three or more organ systems, presence of acute kidney injury, thrombocytopenia and raised serum C‐reactive protein were found to be independently associated with increased odds of in‐hospital mortality in children admitted with SARS‐CoV‐2 infection.