Prognostic factors of severe COVID-19 pneumonia children in Pattani Hospital

Abstract

Background: COVID-19 pneumonia in children are less common and less severe than in adults. Most of them show milder symptoms and have a better prognosis. Although hypoxia (SpO₂<95%) without respiratory distress is commonly observed, only oxygen supplementation is usually sufficient for therapy. However, comorbidities or other risk factors may cause severe disease and increase mortality.

Objective: The study aims to evaluate the potential risk factors for severe COVID-19 pneumonia in pediatric patients.

Methodology: A retrospective observational cohort study using a prognostic factor research approach was conducted at the Pediatric Department of Pattani Hospital, focusing on pediatric patients under 15 years old with COVID-19 pneumonia admitted from 1 October 2021 to 31 December 2022. All data were obtained from patient records and the Hos-XP program. The statistical analysis included non-parametric trend tests and exact probability tests were used in this study. The  odds ratios (OR) from multivariable ordinal regression analysis were used to compare the results obtained from three groups of patients; the group of non-O₂ treatment, the group of O₂ cannula, O₂ mask or O₂ high flow nasal cannula treatment, and the group of endotracheal intubation treatment or death.

Results: Nineteen of 162 pediatric patients (11.7%) with COVID-19 pneumonia required endotracheal intubation. Four risk factors were identified including age less than one year old (OR 6.32), low weight (OR 3.83) or obesity (OR 9.67), fever >38.5°C (OR 7.85), and anemia (OR 7.28).

Conclusions: Pediatric patients with COVID-19 pneumonia who had potential risk factors to develop severe pneumonia needed hospitalization and anemia treatment should be considered to reduce the need for respiratory intubation and mortality rate.