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10.1016/j.jpeds.2020.11.016

http://scihub22266oqcxt.onion/10.1016/j.jpeds.2020.11.016
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33197493!7666535!33197493
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suck abstract from ncbi


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pmid33197493      J+Pediatr 2021 ; 230 (ä): 23-31.e10
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  • Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth #MMPMID33197493
  • Fernandes DM; Oliveira CR; Guerguis S; Eisenberg R; Choi J; Kim M; Abdelhemid A; Agha R; Agarwal S; Aschner JL; Avner JR; Ballance C; Bock J; Bhavsar SM; Campbell M; Clouser KN; Gesner M; Goldman DL; Hammerschlag MR; Hymes S; Howard A; Jung HJ; Kohlhoff S; Kojaoghlanian T; Lewis R; Nachman S; Naganathan S; Paintsil E; Pall H; Sy S; Wadowski S; Zirinsky E; Cabana MD; Herold BC
  • J Pediatr 2021[Mar]; 230 (ä): 23-31.e10 PMID33197493show ga
  • OBJECTIVE: To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity. STUDY DESIGN: We conducted a multicenter, retrospective, and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at 8 sites in New York, New Jersey, and Connecticut. RESULTS: We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into 3 groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% vs 18%, P = .02). Seven patients (2%) died and 114 (41%) were admitted to the intensive care unit. In multivariable analyses, obesity (OR 3.39, 95% CI 1.26-9.10, P = .02) and hypoxia on admission (OR 4.01; 95% CI 1.14-14.15; P = .03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR 8.33 per unit decrease in 10(9) cells/L, 95% CI 2.32-33.33, P = .001) and greater C-reactive protein (OR 1.06 per unit increase in mg/dL, 95% CI 1.01-1.12, P = .017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity. CONCLUSIONS: We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.
  • |*Hospitalization[MESH]
  • |*Severity of Illness Index[MESH]
  • |Adolescent[MESH]
  • |Biomarkers/analysis[MESH]
  • |C-Reactive Protein/analysis[MESH]
  • |COVID-19/blood/*epidemiology[MESH]
  • |Child[MESH]
  • |Child, Preschool[MESH]
  • |Connecticut/epidemiology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Hypoxia/epidemiology[MESH]
  • |Infant[MESH]
  • |Intensive Care Units[MESH]
  • |Lymphocyte Count[MESH]
  • |Male[MESH]
  • |Multivariate Analysis[MESH]
  • |New Jersey/epidemiology[MESH]
  • |New York/epidemiology[MESH]
  • |Pediatric Obesity/epidemiology[MESH]
  • |Procalcitonin/blood[MESH]
  • |Prospective Studies[MESH]
  • |Retrospective Studies[MESH]
  • |Systemic Inflammatory Response Syndrome/blood/*epidemiology[MESH]
  • |Troponin/blood[MESH]


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