儿童 COVID-19 患者入住重症监护室的风险因素 - 德国全国住院病人抽样调查结果。

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2024-11-23 DOI:10.1016/j.rmed.2024.107880

Karsten Keller , Ingo Sagoschen , Volker H. Schmitt , Visvakanth Sivanathan , Ioannis T. Farmakis , Omar Hahad , Sebastian Koelmel , Frank P. Schmidt , Christine Espinola-Klein , Stavros Konstantinides , Thomas Münzel , Philipp Lurz , Lukas Hobohm

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引用次数: 0

摘要

背景：COVID-19大流行病的研究工作主要集中在成年人身上，但儿科人群的数据却很少：我们使用了德国全国住院病人样本，分析了 2020 年期间德国所有确诊 COVID-19 的 18 岁以下住院儿童，并根据入住 ICU 的情况进行了分层：2020年，德国共有3360例18岁以下儿童确诊感染COVID-19（中位年龄7.0 [IQR0.0-15.0]岁，49.8%为女性），其中4.3%入住重症监护室。有 5 名患者在住院期间死亡，3 名未入住重症监护室（3.5% 对 0.1%）：德国COVID-19住院儿科患者入住重症监护室的比例较低，仅为4.3%，病死率为3.5%。入住 ICU 的独立因素包括心血管风险因素、合并症和 COVID-19 并发症。

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Risk factors for intensive care admission in childhood patients with COVID-19 - Results of the German nationwide inpatient sample

Background

COVID-19 pandemic research efforts have mainly focused on adults, but data in paediatric populations are sparse.

Methods

We used the German nationwide-inpatient-sample analysing all hospitalized children ≤18 years with confirmed COVID-19-diagnosis in Germany during the year 2020, stratified for intensive care unit (ICU) admission.

Results

Overall, 3360 hospitalization-cases of children ≤18 years with COVID-19-infection were diagnosed in Germany 2020 (median age 7.0 [IQR 0.0–15.0] years, 49.8 % female); among them 4.3 % were admitted on an ICU. In-hospital death occurred in five patients with and three without ICU admission (3.5 % vs. 0.1 %, P < 0.001) and ICU admission was independently associated with increased case-fatality (OR 21.573 [95%CI 4.191–111.044], P < 0.001).

Obesity (OR 3.419 [95%CI 1.300–8.993], P = 0.013), diabetes mellitus (OR 6.929 [95%CI 3.327–14.432], P < 0.001), pneumonia (OR 7.373 [95%CI 4.823–11.271], P < 0.001), acute respiratory distress syndrome (ARDS) (OR 48.058 [95%CI 11.689–197.588], P < 0.001) and multisystem inflammatory syndrome caused by COVID-19 (OR 9.573 [95%CI 3.036–30.191], P < 0.001), heart failure (OR 64.509 [95%CI 24.462–170.121], P < 0.001), myocarditis (OR 4.682 [95%CI 1.278–17.149], P = 0.020), acute and/or chronic kidney failure (OR 7.946 [95%CI 3.606–17.508], P < 0.001), cancer (OR 5.220 [95%CI 2.599–10.485], P < 0.001) and liver diseases (OR 5.501 [95%CI 2.177–13.899], P < 0.001) were associated with an ICU admission.

Conclusion

Proportion of hospitalized paediatric COVID-19-patients admitted on ICU in Germany was low with 4.3 % accompanied by 3.5 % case-fatality rate. Independent factors for ICU admission comprised cardio-vascular risk factors, comorbidities, and complications of COVID-19.

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.