Mortalidade em crianças internadas por COVID-19: estudo retrospectivo em Hospital Escola Infantil

Abstract

Introduction: COVID-19 is an acute respiratory infection potentially severe caused by SARS-CoV-2. Adults and the elderly are the age groups most affected, with higher rates of infection, complications, and deaths. The majority of pediatric patients are asymptomatic or present mild to moderate symptoms. Objective: The objective of the present study was to evaluate the main causes of COVID-19-related death in the Hospital de Base (HB) and Children's and Maternity Hospital (Hospital da Criança e Maternidade - HCM) complex in São Jose do Rio Preto, SP, Brazil. Casuistic and Methods: A retrospective observational study analyzed COVID-19-related in-hospital mortality by revisiting medical records from between 2020 and 2023 of patients admitted to the hospital complex. All under 19-year-old patients admitted with COVID- 19 in the two hospitals were included in this study. Patients negative for COVID-19 but hospitalized for other illesses during this period were excluded. All data on hospitalized under 19-year-olds were collected. COVID-19 patients were grouped by age (<1 year, from 1 to 4 years, from 5 to 9 years, from 10 to 14 years, from 15 to 19 years and then by decades up to 100 years) with their comorbidities and deaths being recorded. Results: A total of 8986 COVID-19 positive patients were hospitalized between March 2020 and July 2023; 383 (4.26%) of the cases were under 19-year-olds and 8603 (95.73%) were older than 19. General mortality in the 19-year-old group was 12 (3.13%) equivalents to 0.13% of the total deaths from COVID-19. Mortality in the over 19-year-old group was 2197 (25.53%) representing (99.45%) of overall deaths. Mortality in adults was significantly higher (Chi-square test: 98.127501; p-value < 0.0001). There were no statistically significant differences between the age groups of children and adolescents (Fisher's exact test: p-value = 0.3). Cardiomyopathies, Down syndrome, heart valve correction and hydrocephalus were the main comorbidities associated with child mortality in this study. To analyze the behavior of the main viral infections in the two hospitals, it was shown to be higher in this period due to COVID- 19. Conclusion: The Hospital de Base/Maternal and Children's Hospital complex had a significant number of patients hospitalized for COVID-19 with mortality rates varying according to age. Infant mortality at the institution was among the best in the world, with heart disease being the most common cause.