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CHARACTERISTICS OF CHILDREN (
Abstract
Background
Children and adolescents with SARS-CoV-2 infection (COVID-19) are less likely to have severe pneumonia but may present with multisystem inflammatory syndrome (MIS-C) and both these conditions have low mortality. There are limited data on the characteristics and outcomes of children with severe COVID-19 and MIS-C requiring paediatric intensive care (PICU) from resource-limited settings.
Aims
We aim to describe the indications for admission and the outcomes of patients admitted to PICU at Tygerberg Hospital in Cape Town, South Africa.
Methods
Retrospective review of patients < 13 years admitted to PICU with COVID-19 or MIS-C from 17 April 2020 to 31 August 2021.
Results
Sixty three patients required PICU. Twenty-three (36.5%) had MIS-C, 35 (55.5%) had severe COVID-19 and in five (7.9%) children the COVID-19 was thought to be incidental. Patients with MIS-C were older (median age 84 months, IQR 48.0-108.0) than those admitted with severe COVID 19 (median age 20.5 months, IQR 7.0-57.5). Co-morbid disease was more common in children with severe COVID-19 (18/35, 51.4%), than in children with MIS-C (4/23, 17,4%). No children with MIS-C died, but 10 out of 35 children with severe COVID-19 died (28.6%). Of the children admitted to PICU with severe COVID-19 23/35 (63.8%) required invasive ventilation and 15/35 (35.7%) inotropic support. More children with MISC required inotropic support (15/23, 65%).
Conclusions
This cohort is small, but we are concerned that in this group of children with COVID-19 mortality is high once admission to PICU is required. Children with MIS-C had good outcomes.