In:
Open Forum Infectious Diseases, Oxford University Press (OUP)
Abstract:
To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among SARS-CoV-2 infected children and determined if SARS-CoV-2 test result status modified the associations. Methods We conducted a cross-sectional analysis of participants tested for SARS-CoV-2 infection in 41 pediatric emergency departments in 10 countries. Participants were hospitalized, had laboratory testing performed, and completed 14-day follow-up. The primary objective was to assess the associations between laboratory findings and severe outcomes. The secondary outcome was to determine if the SARS-CoV-2 test result modified the associations. Results We included 1817 participants; 522 (28.7%) SARS-CoV-2 test-positive and 1295 (71.3%) test-negative. Seventy-five (14.4%) test-positive and 174 (13.4%) test-negative children experienced severe outcomes. In regression analysis, we found that among SARS-CoV-2 positive children, procalcitonin ≥0.5 ng/mL [9.14 (2.90, 28.80)], ferritin & gt;500 ng/mL [aOR (95%CI): 7.95 (1.89, 33.44)], D-dimer ≥1500 ng/mL [4.57 (1.12, 18.68)] , serum glucose ≥120 mg/dL [2.01 (1.06, 3.81)], and lymphocyte count & lt;1.0×109/L [3.21 (1.34, 7.69)], and platelet count & lt;150×109/L [2.82 (1.31, 6.07)] were associated with severe outcomes. Evaluation of the interaction term revealed that a positive SARS-CoV-2 result increased the associations with severe outcomes for elevated procalcitonin, C-Reactive Protein (CRP), D-dimer, and for reduced lymphocyte and platelet counts. Conclusions Specific laboratory parameters are associated with severe outcomes in SARS-CoV-2-infected children and elevated serum procalcitonin, CRP, and D-dimer, and low absolute lymphocyte and platelet counts were more strongly associated with severe outcomes in children testing positive compared to those testing negative.
Type of Medium:
Online Resource
ISSN:
2328-8957
DOI:
10.1093/ofid/ofad485
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2023
detail.hit.zdb_id:
2757767-3
