Investigation of the Clinical Manifestations of COVID-19 in Critically Ill Children Admitted to the Pediatric Intensive Care Unit of Firouzabadi Hospital in 2020-2021

Background: Considering the epidemiological importance of COVID-19 disease, the high percentage of hospitalization, and the need to prevent morbimortality caused by this disease in children, this study was undertaken to determine the clinical manifestations of COVID disease in critically ill children who need hospitalization in a pediatric intensive care unit (PICU). Methods: In this retrospective cross-sectional study, the population included critically ill children with COVID-19 who were hospitalized in the PICU of Firozabadi Hospital (Tehran, Iran) between 2020 and 2021. The study patients were examined in terms of clinical manifestations, laboratory results, course of the disease, and duration of hospitalization. From the patients' clinical records, the required information was extracted based on the variables and recorded in a pre-designed form. The obtained data were finally entered into SPSS software version 26 for statistical analysis. Results: Among 80 patients examined, 44 (55%) were male, and 36 (45%) were female. The average age of the examined patients was 9.9±5.3 years (1-18 years). In terms of COVID-19 symptoms, the fever had the highest frequency in 65 patients (81.3%), followed by gastrointestinal, respiratory, and neurological symptoms in 41 (51.3%), 39 (48.8%), and 29 (36.3%) cases, respectively. Also, 13 (16.2%) patients had an underlying disease, and 17 (21.3%) patients died from COVID-19. Investigating the relationship between the underlying disease and patients’ deaths showed to be statistically significant (P = 0.002); in other words, having an underlying disease was significantly associated with a high mortality percentage (53.8% vs. 14.9%). Conclusion: This study suggest that children with underlying diseases show higher mortality from COVID-19; therefore, it is necessary to prioritize the provision of medical services to children with underlying diseases in health system policies and patient management.