High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru

Coronado Munoz A.; Tasayco J.; Morales W.; Moreno L.; Zorrilla D.; Stapleton A.; Pajuelo P.; Reyes G.; Estupiñan M.; Seminario R.; Ortiz M.; Domínguez J. · Pediatric Research (2022) · DOI: 10.1038/s41390-021-01547-x

Resumen

Introduction: Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting. Methods: Prospective case–control study that included patients <17 years old admitted to a pediatric critical care unit with a positive test confirming COVID-19. The primary outcome was mortality. Fisher’s exact test and the Mann–Whitney U test were used for the analysis. Results: Forty-seven patients were admitted to critical care. The mortality of our study is 21.3%. The mortality of patients with neurological presentation was 45.5%, which was significantly higher than the mortality of acute COVID-19 (26.7%) and MIS-C (4.8%), p 0.18. Other risk factors for mortality in our cohort were strokes and comorbidities. Only one patient presenting with hemorrhagic stroke had an undiagnosed comorbidity. Conclusion: Cerebrovascular events associated with COVID-19 in pediatric patients, including infants, must be recognized as one of the more severe presentations of this infection in pediatric patients. Impact: Pediatric patients with COVID-19 can present with hemorrhagic and ischemic strokes on presentation.Neurological presentation in pediatric patients with COVID-19 has high mortality.Mortality of pediatric patients with COVID-19 is associated with comorbidities.Pediatric presentation and outcomes of COVID-19 in different regions can be novel to previously described.