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Hastanemiz Çocuk Yoğun Bakım Ünitesine Kabul Edilen COVID-19 Hastalarının Klinik Özellikleri ve Tedavileri

Year 2022, Volume 10, Issue 1, 26 - 31, 15.03.2022
https://doi.org/10.21765/pprjournal.1064688

Abstract

Amaç: Bu çalışmanın amacı Çocuk Yoğun Bakım Ünitesine yatan COVID-19 hastaların klinik ve laboratuvar bulgularını değerlendirmek ve tedavi seçeneklerini saptamaktı. Gereçler ve Yöntem: Otuz iki yataklı Ankara şehir Hastanesi çocuk yoğun bakım ünitesine (ÇYBÜ) kabul edilen hastalardan 16 Mart 2020 ile 16 Aralık 2021 tarihleri arasında COVID-19 tanısı almış hastalar retrospektif olarak tarandı. Vakalarda yaş, cisiyet, temas hikayesi, eşlik eden hastalıklar carekteristik bulgular olarak toplandı. Laboratuvar parametreleri olarak tam kan sayımı, Rütin Biyokimya, akciğer grafisi, toraks comporize tomografisi değerlendirildi. Solunum destek tedavisi ve ekstrakorparyal tedavi, medikal tedaviler kaydedildi. Bulgular: COVID-19 tanısı alıp ÇYBÜ’ ne kabul edilen hasta sayısı 82 idi. Toplam Hastaların %64,6(n=53) erkekdi. Hastaların median yaş 126,5(37-185) aydı. Hastaların yarısına yakını SpO2 değeri %92’nin altında idi. Hastaların yaklaşık yarısında lenfopeni, anemi, CRP ve D-Dimer yüksekliği görüldü. Hastaların %60 (n:47) noninvaziv mekanik ventilasyon (NIV) veya yüksek akımlı nazal oksijen tedavisi (HFNC), desteğine alınırken %35(n:28) invaziv mekanik ventilatörde gözlendi. ÇYBB'de kalış süresi 11 gün, hastanede kalış süresi ise 19 gündü. On iki hasta (%15.2) öldü. Sonuç: Bizim çalışmamızda ve önceki çalışmalarda olduğu gibi, COVID-19' un klinik semptomları, laboratuvar verileri ve göğüs radyografileri için tanısal eksikliği bir nebze gidermek ve literatüre katkıda bulunmaktı.

References

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  • 2. World Health Organisation WHO Coronavirus Disease (COVİD-19) Dashboard. Available at http://covid19.who.int. Accessed march 22,2021.
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  • 4. Riphagen S, Gomez X, Gonzalez-Martinez C et al. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020 May 23;395(10237):1607-1608.
  • 5. Souza TH, Nadal JA, Nogueira RJN et al. Clinical manifestations of children with COVID-19: A systematic review. Pediatr Pulmonol 2020 Jun 3;10.1002.
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  • 7. Villeneuve A, Joyal JS, Proulx F et al. Multiple organ dysfunction syndrome in critically ill children: clinical value of two lists of diagnostic criteria. Ann Intensive Care 2016 Dec;6(1):40. 8. Fang Y, Zhang H, Xie J et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR Radiology 2020.
  • 9. Pan F, Ye T, Sun P et al. Time Course of Lung Changes of Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology 2020 Jun;295(3):715-721.
  • 10. Zheng F, Liao C, Fan Q et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci 2020 Apr;40(2):275-280.
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  • 12. Lu X, Zhang L, Du H, Chinese Pediatric Novel Coronavirus Study Team et al. SARS-CoV-2 Infection in Children. N Engl J Med 2020 Apr 23; 382(17):1663-1665.
  • 13. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama 2020 Mar 17;323(11):1061-1069.
  • 14. Zheng F, Liao C, Fan QH et al. Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China. Curr Med Sci 2020 Apr; 40(2):275-280.
  • 15. Guan WJ, Ni ZY, Hu Y et al. Clinical characteristics of 2019 novel coronavirus infection in China. NEJM 2020 Apr 30;382(18):1708-1720.
  • 16. Alexandra M. Foust, Abbey J. Winant, Winnie C. Chu et al. Pediatric SARS, H1N1, MERS, EVALI, and Now Coronavirus Disease (COVID-19) Pneumonia: What Radiologists Need to Know. Am J Roentgenol 2020 Sep;215(3):736-744.
  • 17. Oterino Serrano C, Alonso E, Andrés M et al. Pediatric chest x-ray in covid-19 infection. Eur J Radiol 2020 Oct;131:109236. 18. Steinberger S, Lin B, Bernheim A et al. CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients. Am J Roentgenol 2020;215(6):1303–11.
  • 19. Liu J, Cao R, Xu M et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov 2020 Mar 18;6:16
  • 20. Gautret P, Lagier JC, Parola P et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020 Jul; 56(1):105949.
  • 21. Ma H, Shao J, Wang Y, et al. High resolution CT features of novel coronavirus pneumonia in children. Zhonghua Fang She Xue Za Zhi 2020 Feb 11;54(0):E002.
  • 22. Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
  • 23. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061–1069.
  • 24. Chen N, Zhou M, Dong X et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507–513.
  • 25. Lee H, Harris K.M, Gordon-Larsen P. Life course perspectives on the links between poverty and obesity during the transition to young adulthood. Popul Res Policy Rev. 2009;28:505–532.
  • 26. Arentz M, Yim E, Klaff L. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020;323:1574–1581.
  • 27. Bhatraju P.K, Ghassemieh B.J, Nichols M et al. Covid-19 in critically ill patients in the Seattle region-case series. N Engl J Med 2020;382:2012–2022.

Clinical Characteristics and Treatment of COVID-19 Patients Admitted to the Pediatric Intensive Care Unit in Our Center

Year 2022, Volume 10, Issue 1, 26 - 31, 15.03.2022
https://doi.org/10.21765/pprjournal.1064688

Abstract

Aim: The aim of this study was to evaluate the clinical and laboratory findings and to determine the treatment options of COVID-19 patients hospitalized in the Pediatric Intensive Care Unit. Materials and Methods: We retrospectively reviewed the patients who were diagnosed with COVID-19 and admitted to the pediatric intensive care unit (PICU) with 32 beds in Ankara City Hospital between March 16, 2020 and December 16, 2021. Patient characteristics included age, gender, contact history, and co-morbidities. Laboratory investigations included complete blood count, biochemical evaluations, chest X-ray, and computed tomographic imaging of the thorax. Respiratory support therapy and extracorporeal therapy, and other medical treatments were recorded. Results: A total of 82 patients were admitted to the PICU after being diagnosed with COVID-19. Of all patients 64.6% (n=53) were male. The median age of the patients was 126.5 (37-185) months. Nearly half of the patients had a SpO2 below 92%. About half of the patients had lymphopenia, anemia, and elevated CRP and D-Dimer levels. Of the patients, 60% (n=47) were supported with non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) oxygen therapy, whereas 35% (n=28) were followed on invasive mechanical ventilation. The length of stay in the PICU was 11 days, whereas the total length of stay in the hospital was 19 days. Twelve patients (15.2%) died. Conclusion: In line with previous studies, our study planned to contribute to the literature in order to fill the diagnostic gap through clinical findings, laboratory values and chest radiographic examinations in COVID-19.

References

  • 1. Chan JFW, Yuan S, Kok KH et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet 2020;395:514-523.
  • 2. World Health Organisation WHO Coronavirus Disease (COVİD-19) Dashboard. Available at http://covid19.who.int. Accessed march 22,2021.
  • 3. Baker T, Schell CO, Peterson DB et al. Essential Care of Critical Illness Must Not Be Forgotten in the COVID-19 Pandemic. The Lancet 2020;395:1253-125.
  • 4. Riphagen S, Gomez X, Gonzalez-Martinez C et al. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020 May 23;395(10237):1607-1608.
  • 5. Souza TH, Nadal JA, Nogueira RJN et al. Clinical manifestations of children with COVID-19: A systematic review. Pediatr Pulmonol 2020 Jun 3;10.1002.
  • 6. Peikai H, Tianzhu L, Lesheng H et al. Use of Chest CT in Combination with Negative RT-PCR Assay for the 2019 Novel Coronavirus but High Clinical Suspicion. Radiology 2020;295(1): 22–23.
  • 7. Villeneuve A, Joyal JS, Proulx F et al. Multiple organ dysfunction syndrome in critically ill children: clinical value of two lists of diagnostic criteria. Ann Intensive Care 2016 Dec;6(1):40. 8. Fang Y, Zhang H, Xie J et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR Radiology 2020.
  • 9. Pan F, Ye T, Sun P et al. Time Course of Lung Changes of Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology 2020 Jun;295(3):715-721.
  • 10. Zheng F, Liao C, Fan Q et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci 2020 Apr;40(2):275-280.
  • 11. Qiu H, Wu J, Hong L et al. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020;20:689–696.
  • 12. Lu X, Zhang L, Du H, Chinese Pediatric Novel Coronavirus Study Team et al. SARS-CoV-2 Infection in Children. N Engl J Med 2020 Apr 23; 382(17):1663-1665.
  • 13. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama 2020 Mar 17;323(11):1061-1069.
  • 14. Zheng F, Liao C, Fan QH et al. Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China. Curr Med Sci 2020 Apr; 40(2):275-280.
  • 15. Guan WJ, Ni ZY, Hu Y et al. Clinical characteristics of 2019 novel coronavirus infection in China. NEJM 2020 Apr 30;382(18):1708-1720.
  • 16. Alexandra M. Foust, Abbey J. Winant, Winnie C. Chu et al. Pediatric SARS, H1N1, MERS, EVALI, and Now Coronavirus Disease (COVID-19) Pneumonia: What Radiologists Need to Know. Am J Roentgenol 2020 Sep;215(3):736-744.
  • 17. Oterino Serrano C, Alonso E, Andrés M et al. Pediatric chest x-ray in covid-19 infection. Eur J Radiol 2020 Oct;131:109236. 18. Steinberger S, Lin B, Bernheim A et al. CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients. Am J Roentgenol 2020;215(6):1303–11.
  • 19. Liu J, Cao R, Xu M et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov 2020 Mar 18;6:16
  • 20. Gautret P, Lagier JC, Parola P et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020 Jul; 56(1):105949.
  • 21. Ma H, Shao J, Wang Y, et al. High resolution CT features of novel coronavirus pneumonia in children. Zhonghua Fang She Xue Za Zhi 2020 Feb 11;54(0):E002.
  • 22. Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
  • 23. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061–1069.
  • 24. Chen N, Zhou M, Dong X et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507–513.
  • 25. Lee H, Harris K.M, Gordon-Larsen P. Life course perspectives on the links between poverty and obesity during the transition to young adulthood. Popul Res Policy Rev. 2009;28:505–532.
  • 26. Arentz M, Yim E, Klaff L. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020;323:1574–1581.
  • 27. Bhatraju P.K, Ghassemieh B.J, Nichols M et al. Covid-19 in critically ill patients in the Seattle region-case series. N Engl J Med 2020;382:2012–2022.

Details

Primary Language English
Subjects Health Care Sciences and Services
Journal Section Original Articles
Authors

Oktay PERK (Primary Author)
Ankara şehir hastanesi
0000-0002-2586-5954
Türkiye


Serhan ÖZCAN
Ankara Şehir Hastanesi
0000-0003-4465-6063
Türkiye


Serhat EMEKSİZ
Ankara Şehir Hastanesi
0000-0002-8951-4774
Türkiye


Emel UYAR
Ankara Şehir Hastanesi
0000-0002-8265-0618
Türkiye


Belgin GÜLHAN
Ankara Şehir Hastanesi
0000-0003-0839-1301
Türkiye


Ahmet Yasin GÜNEY
Ankara Şehir Hastanesi
0000-0002-3446-7034
Türkiye


Saliha KANIK YÜKSEK
Ankara Şehir Hastanesi
0000-0002-2538-2872
Türkiye


Ayşe YILMAZ CANDAR
Ankara Şehir Hastanesi
0000-0002-7005-2813
Türkiye

Supporting Institution yok
Project Number -
Publication Date March 15, 2022
Acceptance Date March 6, 2022
Published in Issue Year 2022, Volume 10, Issue 1

Cite

Vancouver Perk O. , Özcan S. , Emeksiz S. , Uyar E. , Gülhan B. , Güney A. Y. , Kanık Yüksek S. , Yılmaz Candar A. Clinical Characteristics and Treatment of COVID-19 Patients Admitted to the Pediatric Intensive Care Unit in Our Center. Pediatric Practice and Research. 2022; 10(1): 26-31.