Risk factor of respiratory failure in pediatric SARS-CoV-2 infection patients
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Abstract
BACKGROUND: Respiratory failure in children with COVID-19 poses a critical challenge to a public health system. Consequently, identifying risk factors associated with respiratory failure in pediatric patients suffering from COVID-19 is crucial.
OBJECTIVE: To study risk factors associating with respiratory failure in pediatric patients with diagnosed COVID-19.
METHODS: This case-control study involved collecting data from patients under 15 years of age diagnosed with COVID-19, treated at Chiangrai Prachanukroh Hospital in January to December 2022. We compared clinical factors between patients who needed mechanical ventilation and those who did not. Statistical analysis was done using logistic regression.
RESULTS: One hundred and ten patients were included in the study, comprising 57 males and 53 females, divided into two groups: 22 patients needed mechanical ventilation and 88 patients did not. Among the ventilated patients, 14 (63.63%) had comorbidities, including asthma (4.55%), cardiovascular diseases (22.73%), obesity (31.82%), and diabetes (13.64%). All of the ventilated patients were hospitalized during the outbreak of Omicron variant. Comorbidities in the ventilated group included chronic pulmonary disease, croup, and pneumonia. Factors associated with respiratory failure in pediatric patients diagnosed with COVID-19 were obesity (adjusted OR 63.99; 95% CI 1.07-3.82 x 10³, p-value 0.046), croup (adjusted OR 396.47; 95% CI 7.22-2.18x10⁴, p-value 0.003), white blood cell count over 10,000 (adjusted OR 63.99; 95% CI 2.80-3.05x10², p-value 0.046), and an absolute lymphocyte count < 1500 (adjusted OR 19.14; 95% CI 2.59-1.41x10², p-value 0.004)
CONCLUSIONS AND RECOMMENDATIONS: This study identified obesity, croup, elevated white blood cell counts, and low absolute lymphocyte counts as significant risk factors for respiratory failure in pediatric patients diagnosed with COVID-19. Consequently, it is essential for clinicians to closely monitor and strategically manage pediatric patients with these risk factors in the clinical setting of COVID-19 treatment.
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