Clinical and Radiological Characteristics of Critically Ill Children with COVID-19 Disease Presenting to a Resources Limited Setting Paediatric Intensive Care Unit

Patience Kwawu, Obed Otoo, Larko D Owusu, Eugene Martey, John Adabie Appiah
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Abstract

 BackgroundIn March 2020, WHO declared COVID-19 disease caused by SARS-nCOV-2 as a pandemic. COVID-19 is characterized by a spectrum of disease syndrome commonly affecting respiratory system. Progression to severe and critical disease is seen in 20% of confirmed cases. Childhood clinical presentation and radiological features children in resource limited settings including Africa has been less described in literature. Study aimed to describe common clinical characteristics and radiological features of childhood covid-19 disease with critical illness. Methods Electronic records of paediatric patients aged 2 months to 14 years admitted to PICU of KATH between the period of 1st February - 31st August 2021 were respective reviewed. Clinical features were collected using a case record form and radiological features reviewed by radiologist. ResultsPICU admitted 78 patients during the study, 8 covid-19 cases (10%); 7 confirmed and 1 probable. The median age 4 years (0-14 years), 6 males. The most common presenting features include; altered level of consciousness, breathlessness, and fever. The respiratory system was the most common site of presentation followed by circulatory system. Associated co morbid condition on admission includes sickle cell disease and road traffic accident. Six out of 7 had CXR showing abnormal features; 4 had ground glass appearance, 3 with consolidations, reticulo-nodular and pleural effusion respectively, and peri-bronchial thickening 2. Three (37.5%) presented as ARDS with severe hypoxaemia4. Echocardiography in 2 patients showed abnormalities: myocardial dysfunction, pericardial effusion and right ventricular failure. Seven (87%) received mechanical ventilation and 2 (25%) received inotrope support. PICU survival was 75% about half of the overall outcome reported on the continent2. ConclusionThis study shows that COVID-19 and radiological features suggest severity of illness requiring critical care services including mechanical ventilation and inotrope therapy(Please rephrase sentence). Early identification and referral to centres with PICU capacity are needed for management.
资源有限的儿科重症监护室新冠肺炎危重患儿的临床和影像学特征
2020年3月,世卫组织宣布由SARS-nCOV-2引起的COVID-19疾病为大流行。COVID-19的特点是通常影响呼吸系统的一系列疾病综合征。20%的确诊病例进展为严重和危重症。包括非洲在内的资源有限地区儿童的临床表现和放射学特征在文献中描述较少。本研究旨在描述儿童covid-19疾病合并危重症的常见临床特征和影像学特征。方法对2021年2月1日至8月31日期间入住KATH PICU的2个月至14岁儿童患者的电子记录进行分析。临床特征收集使用病例记录表和放射学特征由放射科医生审查。结果spicu共收治78例患者,其中covid-19 8例(占10%);确诊7例,疑似1例。中位年龄4岁(0-14岁),男性6例。最常见的呈现特征包括;意识水平改变,呼吸困难,发烧。呼吸系统是最常见的表现部位,其次是循环系统。入院时的相关合并症包括镰状细胞病和道路交通事故。7人中有6人的CXR显示异常特征;磨玻璃样4例,实变、网状结节、胸腔积液3例,支气管周围增厚2例。3例(37.5%)为ARDS合并重度低氧血症4。2例超声心动图显示异常:心肌功能障碍、心包积液、右心衰。7例(87%)接受机械通气,2例(25%)接受肌力支持。PICU生存率为75%,约为非洲大陆报道的总结果的一半2。结论本研究显示COVID-19和影像学特征表明疾病严重程度需要重症监护服务,包括机械通气和肌力治疗(请重新措辞)。需要早期识别并转诊到具有PICU能力的中心进行管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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