By Ethan Covey
Mortality rates among children with COVID-19 admitted to a pediatric ICU (PICU) are similar to average PICU admissions, according to data presented at the Society of Critical Care Medicine’s 50th Critical Care Congress Virtual Event (abstract 64).
However, the study found more than 70% of PICU patients who were diagnosed with COVID-19 were nonwhite, highlighting an increased risk among even the youngest people of color.
“Factors associated with outcomes of children in the PICU with COVID-19 have not been fully studied particularly after adjusting for underlying severity of illness,” said Ramesh C. Sachdeva, MD, the senior vice president and chief clinical officer at Nicklaus Children's Hospital, in Miami.
The study involved 1,528 patients younger than 18 years with a confirmed diagnosis of COVID-19, admitted between December 2019 and December 2020, according to data from the Virtual Pediatric Systems (VPS) registry.
PRISM III pediatric mortality scores were reviewed based on age, body mass index (BMI), weight, invasive ventilator days and length of stay.Overall, 97.6% of the patients survived. The average age of patients who survived was slightly lower than those who died, at 9.8 versus 11.4 years.
“Of note,” Sachdeva said, “there was a significant proportion of children admitted who were nonwhite, with Blacks and Hispanics representing the vast majority of nonwhite children.”
However, even though there was a higher proportion of children who were nonwhite in the PICU compared with the proportion in the VPS data set, the mortality rate among nonwhite and white children was similar. Age, BMI and weight were significantly correlated with more severe illness in the nonobese subgroup.
The logistic regression models showed that PRISM III accurately predicted mortality among the PICU patients. In addition, the regression models suggested that boys may be at particular risk for poor outcomes among the patients.
Sachdeva noted that future study could shine a light on certain questions raised by the study.
“Results from these analyses should be tested farther to better understand the clinical implications of the correlations and associations identified,” he said. “The logistic regression models should also be further refined to validate the results observed in these analyses using additional data. And, importantly, the initial trends noted in this study, particularly including the racial disparities identified, should be further tested in the VPS registry as the epidemiology of COVID-19 continues to evolve.”
