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dc.contributor.authorDerespina, Kim R
dc.contributor.authorKaushik, Shubhi
dc.contributor.authorPlichta, Anna
dc.contributor.authorConway, Edward E
dc.contributor.authorBercow, Asher
dc.contributor.authorChoi, Jaeun
dc.contributor.authorEisenberg, Ruth
dc.contributor.authorGillen, Jennifer
dc.contributor.authorSen, Anita I
dc.contributor.authorHennigan, Claire M
dc.contributor.authorZerihun, Lillian M
dc.contributor.authorDoymaz, Sule
dc.contributor.authorKeenaghan, Michael A
dc.contributor.authorJarrin, Stephanie
dc.contributor.authorOulds, Franscene
dc.contributor.authorGupta, Manoj
dc.contributor.authorPierre, Louisdon
dc.contributor.authorGrageda, Melissa
dc.contributor.authorUshay, H Michael
dc.contributor.authorNadkarni, Vinay M
dc.contributor.authorAgus, Michael S D
dc.contributor.authorMedar, Shivanand S
dc.identifier.citationDerespina KR, Kaushik S, Plichta A, Conway EE Jr, Bercow A, Choi J, Eisenberg R, Gillen J, Sen AI, Hennigan CM, Zerihun LM, Doymaz S, Keenaghan MA, Jarrin S, Oulds F, Gupta M, Pierre L, Grageda M, Ushay HM, Nadkarni VM, Agus MSD, Medar SS. Clinical Manifestations and Outcomes of Critically Ill Children and Adolescents with Coronavirus Disease 2019 in New York City. J Pediatr. 2020 Nov;226:55-63.e2. doi: 10.1016/j.jpeds.2020.07.039. Epub 2020 Jul 16. PMID: 32681989; PMCID: PMC7363610.en_US
dc.description.abstractObjectives: To describe the clinical manifestations and outcomes of critically ill children with coronavirus disease-19 (COVID-19) in New York City. Study design: Retrospective observational study of children 1 month to 21 years admitted March 14 to May 2, 2020, to 9 New York City pediatric intensive care units (PICUs) with severe acute respiratory syndrome coronavirus 2 infection. Results: Of 70 children admitted to PICUs, median age was 15 (IQR 9, 19) years; 61.4% male; 38.6% Hispanic; 32.9% black; and 74.3% with comorbidities. Fever (72.9%) and cough (71.4%) were the common presenting symptoms. Twelve patients (17%) met severe sepsis criteria; 14 (20%) required vasopressor support; 21 (30%) developed acute respiratory distress syndrome (ARDS); 9 (12.9%) met acute kidney injury criteria; 1 (1.4%) required renal-replacement therapy, and 2 (2.8%) had cardiac arrest. For treatment, 27 (38.6%) patients received hydroxychloroquine; 13 (18.6%) remdesivir; 23 (32.9%) corticosteroids; 3 (4.3%) tocilizumab; and 1 (1.4%) anakinra; no patient was given immunoglobulin or convalescent plasma. Forty-nine (70%) patients required respiratory support: 14 (20.0%) noninvasive mechanical ventilation, 20 (28.6%) invasive mechanical ventilation (IMV), 7 (10%) prone position, 2 (2.8%) inhaled nitric oxide, and 1 (1.4%) extracorporeal membrane oxygenation. Nine (45%) of the 20 patients requiring IMV were extubated by day 14 with median IMV duration of 218 (IQR 79, 310.4) hours. Presence of ARDS was significantly associated with duration of PICU and hospital stay, and lower probability of PICU and hospital discharge at hospital day 14 (P < .05 for all). Conclusions: Critically ill children with COVID-19 predominantly are adolescents, have comorbidities, and require some form of respiratory support. The presence of ARDS is significantly associated with prolonged PICU and hospital stay.en_US
dc.rightsCopyright © 2020 Elsevier Inc. All rights reserved.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.subjectpediatric ARDSen_US
dc.subjectpediatric respiratory failureen_US
dc.subjectpediatric viral sepsisen_US
dc.titleClinical Manifestations and Outcomes of Critically Ill Children and Adolescents with Coronavirus Disease 2019 in New York City.en_US
dc.source.journaltitleThe Journal of pediatricsen_US
dc.source.countryUnited States
dc.description.institutionSUNY Downstateen_US
dc.identifier.journalThe Journal of pediatrics

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