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World Journal of Pediatrics

20-03-2024 | SARS-CoV-2 | Original Article

Severe acute respiratory syndrome coronavirus-2-related and imputable deaths in children: results from the French pediatric national registry

Authors: Marguerite Lockhart-Bouron, Noémie Vanel, Michael Levy, Anaïs R. Briant, Etienne Javouhey, Sophie Breinig, Julia Dina, Marion Caseris, François Angoulvant, Stéphane Leteurtre, Morgan Recher, David W. Brossier

Published in: World Journal of Pediatrics

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Abstract

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for an important mortality rate worldwide. We aimed to evaluate the actual imputability of SARS-CoV-2 on the mortality rate associated with SARS-CoV-2-related illnesses in the pediatric intensive care unit (PICU). Secondary objectives were to identify risk factors for death.

Methods

This national multicenter comparative study comprised all patients under 18 years old with positive SARS-CoV-2 polymerase chain reactions (PCRs) [acute corona virus disease 2019 (COVID-19) or incidental SARS-CoV-2 infection] and/or pediatric inflammatory multisystem syndrome (PIMS) recorded in the French PICU registry (PICURe) between September 1, 2021, and August 31, 2022. Included patients were classified and compared according to their living status at the end of their PICU stay. Deceased patients were evaluated by four experts in the field of pediatric infectiology and/or pediatric intensive care. The imputability of SARS-CoV-2 as the cause of death was classified into four categories: certain, very probable, possible, or unlikely, and was defined by any of the first three categories.

Results

There were 948 patients included of which 43 died (4.5%). From this, 26 deaths (67%) could be attributed to SARS-CoV-2 infection, with an overall mortality rate of 2.8%. The imputability of death to SARS-CoV-2 was considered certain in only one case (0.1%). Deceased patients suffered more often from comorbidities, especially heart disease, neurological disorders, hematological disease, cancer, and obesity. None of the deceased patients were admitted for pediatric inflammatory multisystem syndrome (PIMS). Mortality risk factors were male gender, cardiac comorbidities, cancer, and acute respiratory distress syndrome.

Conclusions

SARS-CoV-2 mortality in the French pediatric population was low. Even though the imputability of SARS-CoV-2 on mortality was considered in almost two-thirds of cases, this imputability was considered certain in only one case.

Graphical Abstract

Appendix
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Metadata
Title
Severe acute respiratory syndrome coronavirus-2-related and imputable deaths in children: results from the French pediatric national registry
Authors
Marguerite Lockhart-Bouron
Noémie Vanel
Michael Levy
Anaïs R. Briant
Etienne Javouhey
Sophie Breinig
Julia Dina
Marion Caseris
François Angoulvant
Stéphane Leteurtre
Morgan Recher
David W. Brossier
Publication date
20-03-2024
Publisher
Springer Nature Singapore
Published in
World Journal of Pediatrics
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-023-00791-x