Study of Hospitalized Children With COVID-19 Provides Warning Signs For Severe Illness (Spanish)
New Research Identifies Which Children Are Most Likely to Need Intensive Care
NEW YORK, Nov. 18, 2020 /PRNewswire-HISPANIC PR WIRE/ -- Research led by investigators at the Children's Hospital at Montefiore, Albert Einstein College of Medicine and Yale School of Medicine, identifies symptoms that can predict how severely children will be affected by COVID-19. The research, published in the Journal of Pediatrics, shows that children with respiratory disease and those with Multi-System Inflammatory Syndrome (MIS-C), a rare but serious condition associated with COVID-19, experienced the most severe illness.
"Much of the discussion to date around COVID-19 suggests that children don't typically suffer serious illness," said lead author, Danielle Fernandes, M.D., attending physician, Division of Hospital Medicine, CHAM, and assistant professor of pediatrics at Einstein. "Our study shows that children with COVID-19, like adults, can experience symptoms ranging from mild to severe, and tragically, children can die from the disease."
The investigators assessed 281 children hospitalized with COVID-19 disease at eight medical centers in New York, New Jersey and Connecticut between March and May of this year. Half the children had respiratory disease with symptoms including cough, wheezing, sore throat, and difficulty breathing. The remaining 50% of patients were equally divided between children who experienced MIS-C and children who exhibited a range of symptoms, including gastrointestinal issues and fever. Of the three groups, children with MIS-C were most likely to require intensive care, but only children with respiratory illness passed away from COVID-19.
The eight participating hospitals in the tri-state area serve diverse patient populations, however the majority of hospitalized patients in this study were Hispanic or Black. In contrast to studies involving adults with COVID-19, the researchers found that race or ethnicity did not influence how children with COVID-19 fared following hospitalization. Additionally, the study showed:
Children with obesity and those with low oxygen levels at the time of admission were more likely to have severe respiratory disease and require prolonged intensive care;
One in five children with severe respiratory disease required intubation and mechanical ventilation;
Children with lower lymphocytes, a subset of white blood cells, and those with higher levels of C-reactive protein, a test commonly used to evaluate inflammation, were more likely to have severe MIS-C;
Children with MIS-C were more likely to be non-Hispanic Black
Race/ethnicity and socioeconomic status was not associated with more severe disease
"We hope that pediatric providers will use these warning signs to predict which children may need enhanced monitoring and treatment that could prevent them from becoming severely ill or dying," said Dr. Fernandes.
The paper is titled "SARS-CoV-2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth." Co-authors include members of The Tri-State Pediatric COVID-19
Research Consortium from Albert Einstein College of Medicine, the Children's
Hospital at Montefiore, Yale School of Medicine, Kings County Hospital Center, Maimonides Children's Hospital, Joseph M. Sanzari Children's Hospital, K. Hovnanian Children's Hospital, Neptune City, SUNY Downstate Medical Center University Hospital and Stony Brook University Renaissance Hospital
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(Spanish)
Un amplio estudio sobre niƱos ingresados con COVID-19 revela las seƱales que advierten de formas graves de la enfermedad
Una investigaciĆ³n identifica quĆ© niƱos tienen mĆ”s probabilidades de necesitar cuidados intensivos
NUEVA YORK, 18 de noviembre de 2020 /PRNewswire-HISPANIC PR WIRE/ -- Una investigaciĆ³n dirigida por cientĆficos del Children's Hospital at Montefiore, el Albert Einstein College of Medicine y Yale School of Medicine, identifica quĆ© sĆntomas permiten predecir el grado de gravedad que desarrollarĆ”n los niƱos con COVID-19. La investigaciĆ³n, publicada en Journal of Pediatrics, muestra que los niƱos con enfermedades respiratorias y aquellos con una condiciĆ³n poco comĆŗn pero grave propia del COVID-19 denominada sĆndrome inflamatorio multisistĆ©mico (MIS-C por sus siglas en inglĆ©s), desarrollaron formas mĆ”s severas de la enfermedad.
"Hasta la fecha se ha hablado mucho de que los niƱos con COVID-19 no suelen desarrollar formas graves de la enfermedad", comenta la autora principal, Danielle Fernandes, M.D., MĆ©dico Supervisora de la DivisiĆ³n de Medicina Hospitalaria, CHAM, y Profesora Adjunta de PediatrĆa en Einstein. "Nuestro estudio refleja que los niƱos con COVID-19, al igual que los adultos con esta enfermedad, pueden experimentar sĆntomas que van de leves a graves y que, trĆ”gicamente, tambiĆ©n pueden fallecer".
Los investigadores evaluaron a 281 niƱos hospitalizados con COVID-19 en ocho centros mĆ©dicos de Nueva York, Nueva Jersey y Connecticut entre los meses de marzo y mayo del presente aƱo. La mitad de los menores desarrollaron sĆntomas de enfermedad respiratoria, como tos, sibilancia, dolor de garganta y dificultad para respirar. El 50 por ciento restante se dividiĆ³ a partes iguales entre un grupo de niƱos con sĆndrome inflamatorio multisistĆ©mico pediĆ”trico (MIS-C, en sus siglas en inglĆ©s) y otro grupo con sĆntomas diversos, incluidos problemas gastrointestinales y fiebre. De los niƱos que integraron estos tres grupos, los que desarrollaron MIS-C fueron los mĆ”s proclives a requerir cuidados intensivos, pero solo los niƱos con sĆntomas de enfermedad respiratoria fallecieron a causa del COVID-19.
Los ocho hospitales participantes de la regiĆ³n tri-state (NY, NJ y CT) atienden a poblaciones Ć©tnicamente diversas; sin embargo, la mayorĆa de los pacientes hospitalizados en este estudio fueron hispanos o negros. A diferencia de los estudios sobre adultos con COVID-19, los investigadores descubrieron que los factores Ć©tnicos o raciales no influyeron en los resultados mĆ©dicos de los niƱos hospitalizados a causa de esta enfermedad. AdemĆ”s, el estudiĆ³ determinĆ³ que:
Los niƱos con obesidad, por un lado, y tambiĆ©n aquellos con niveles bajos de oxĆgeno en el momento de ser ingresados, fueron mĆ”s proclives a padecer sĆntomas respiratorios graves y a necesitar cuidados intensivos prolongados;
Uno de cada cinco niƱos con enfermedad respiratoria grave requiriĆ³ intubaciĆ³n y ventilaciĆ³n mecĆ”nica;
Los niƱos con niveles mĆ”s bajos de linfocitos (un subgrupo de glĆ³bulos blancos) y aquellos con niveles mĆ”s elevados de proteĆna C reactiva, (un test comĆŗn que evalĆŗa el nivel de inflamaciĆ³n) fueron mĆ”s proclives a desarrollar MIS-C grave;
Los niƱos con MIS-C tendieron a ser negros no hispanos.
No se observĆ³ ningĆŗn vĆnculo entre la raza, la etnicidad y el estatus socioeconĆ³mico con las formas mĆ”s severas de la enfermedad.
"Esperamos que los pediatras tengan en cuenta estas seƱales de advertencia para predecir quĆ© niƱos pueden requerir medidas de control y tratamiento adicionales, que podrĆan evitar el desarrollo de formas graves de la enfermedad y de desenlances fatales", dijo la Dra. Fernandes.
El estudio se titula "SĆndromes clĆnicos del SARS-CoV-2 y predictores de la gravedad de la enfermedad en niƱos y jĆ³venes hospitalizados". Los coautores son miembros del Tri-State Pediatric COVID-19 Research Consortium, integrado por doctores de las siguientes instituciones: Albert Einstein College of Medicine; Children's Hospital at Montefiore; Yale School of Medicine; Kings County Hospital Center; Maimonides Children's Hospital; Joseph M. Sanzari Children's Hospital; K.Hovnanian Children's Hospital; Neptune City; SUNY Downstate Medical Center University Hospital y Stony Brook University Renaissance Hospital.
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