Omar Yassef Antúnez-Montes1, Maria Isabel Escamilla2, Augusto Flavio Figueroa-Uribe3, Erick Arteaga-Menchaca4, Manuel Lavariega-Saráchaga5, Perla Salcedo-Lozada6, Priscilla Melchior7, Rodrigo Beréa de Oliveira7, Juan Carlos Tirado Caballero8, Hernando Pinzon Redondo9, Laura Vanessa Montes Fontalvo9, Roger Hernandez10, Carolina Chavez10, Francisco Campos11, Fadia Uribe11, Olguita Del Aguila12, Jorge Alberto Rios Aida8, Andrea Parra Buitrago2,13, Lina Maria Betancur Londoño13, León Felipe Mendoza Vega14, Carolina Almeida Hernández15, Michela Sali16,17, Julian Esteban Higuita Palacio18, Jessica Gomez-Vargas19, Adriana Yock-Corrales19, Danilo Buonsenso6,17,20,21. 1. From the Departamento de Docencia e Investigación. Instituto Latinoamericano de Ecografía en Medicina (ILEM), Ciudad de México, México. 2. Fundación Neumológica Colombiana, Bogotá, Colombia. 3. Hospital Pediátrico Peralvillo, Secretaria de salud, Ciudad de México, México. 4. Hospital General Regional 200, Instituto Mexicano del Seguro Social, Estado de México, México. 5. Grupo Home Health Medical, Ciudad de México, México. 6. Hospital General de Ecatepec Las Américas Estado de México, México. 7. Sao Luiz Hospital, Sao Paulo, Brazil. 8. Plus Mèdica, Lima, Perù. 9. Hospital Infantil Napoleon Franco Pareja, Cartagena, Colombia. 10. Unidad de Investigacion de Pediatria, Hospital Cayetano Heredia, Lima, Perù. 11. Unidad de Infectologia Pediatrica"; Hospital San Bartolomé, Lima, Perù. 12. Unidad de Infectologia Pediátrica; Hospital Nacional Edgardo Rebagliati Martins. Lima - Perú. 13. Hospital Pablo Tobón Uribe, Medellín, Colombia. 14. Jefe servicio de medicina crítica, Hospital Infantil de Tlaxcala, Tlaxcala, Mexico. 15. Jefatura de pediatria, Hospital general Las Americas, Estado de México, México. 16. Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 17. Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy. 18. Institution Hospital Universitario de San Vicente Fundacion, Medellin, Colombia. 19. Hospital Nacional de Niños ¨Dr. Carlos Sáenz Herrera, San josé, Costa Rica. 20. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 21. Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia.
Abstract
BACKGROUND: To date, there are no comprehensive data on pediatric COVID-19 from Latin America. This study aims to assess COVID-19 and Multisystem Inflammatory Syndrome (MIS-C) in Latin American children, to appropriately plan and allocate resources to face the pandemic on a local and international level. METHODS: Ambispective multicenter cohort study from 5 Latin American countries. Children 18 years of age or younger with microbiologically confirmed SARS-CoV-2 infection or fulfilling MIS-C definition were included. FINDINGS: Four hundred nine children were included, with a median age of 3.0 years (interquartile range 0.6-9.0). Of these, 95 (23.2%) were diagnosed with MIS-C. One hundred ninety-one (46.7%) children were admitted to hospital and 52 (12.7%) required admission to a pediatric intensive care unit. Ninety-two (22.5%) patients required oxygen support: 8 (2%) were started on continuous positive airway pressure and 29 (7%) on mechanical ventilation. Thirty-five (8.5%) patients required inotropic support. The following factors were associated with pediatric intensive care unit admission: preexisting medical condition (P < 0.0001), immunodeficiency (P = 0.01), lower respiratory tract infection (P < 0.0001), gastrointestinal symptoms (P = 0.006), radiologic changes suggestive of pneumonia and acute respiratory distress syndrome (P < 0.0001) and low socioeconomic conditions (P = 0.009). CONCLUSIONS: This study shows a generally more severe form of COVID-19 and a high number of MIS-C in Latin American children, compared with studies from China, Europe and North America, and support current evidence of a more severe disease in Latin/Hispanic children or in people of lower socioeconomic level. The findings highlight an urgent need for more data on COVID-19 in Latin America.
BACKGROUND: To date, there are no comprehensive data on pediatric COVID-19 from Latin America. This study aims to assess COVID-19 and Multisystem Inflammatory Syndrome (MIS-C) in Latin American children, to appropriately plan and allocate resources to face the pandemic on a local and international level. METHODS: Ambispective multicenter cohort study from 5 Latin American countries. Children 18 years of age or younger with microbiologically confirmed SARS-CoV-2 infection or fulfilling MIS-C definition were included. FINDINGS: Four hundred nine children were included, with a median age of 3.0 years (interquartile range 0.6-9.0). Of these, 95 (23.2%) were diagnosed with MIS-C. One hundred ninety-one (46.7%) children were admitted to hospital and 52 (12.7%) required admission to a pediatric intensive care unit. Ninety-two (22.5%) patients required oxygen support: 8 (2%) were started on continuous positive airway pressure and 29 (7%) on mechanical ventilation. Thirty-five (8.5%) patients required inotropic support. The following factors were associated with pediatric intensive care unit admission: preexisting medical condition (P < 0.0001), immunodeficiency (P = 0.01), lower respiratory tract infection (P < 0.0001), gastrointestinal symptoms (P = 0.006), radiologic changes suggestive of pneumonia and acute respiratory distress syndrome (P < 0.0001) and low socioeconomic conditions (P = 0.009). CONCLUSIONS: This study shows a generally more severe form of COVID-19 and a high number of MIS-C in Latin American children, compared with studies from China, Europe and North America, and support current evidence of a more severe disease in Latin/Hispanic children or in people of lower socioeconomic level. The findings highlight an urgent need for more data on COVID-19 in Latin America.