{
    "abstract": "SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo-18\u00a0years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023.\u00a0The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23\u00a0months, 95 (50.8%) were up to 2\u00a0years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11\u00a0days (IQR, 2-28). In the MIS-C group, 56 (70.9%) were male, median age was 23\u00a0months and median follow-up was 162\u00a0days (range, 3-202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4-13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12\u00a0days of hospitalization.",
    "authors": [
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil. emmersonfariasbrandynew@gmail.com.\nDepartment of Pediatric Critical Care, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, 7th Floor, St. Bernal do Couto, 988 - Umarizal, Bel\u00e9m, PA, 66055-080, Brazil. emmersonfariasbrandynew@gmail.com.",
            "firstname": "Emmerson C F",
            "initials": "ECF",
            "lastname": "de Farias"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Manoel J C",
            "initials": "MJC",
            "lastname": "Pav\u00e3o Junior"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Susan C D",
            "initials": "SCD",
            "lastname": "de Sales"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Luciana M P P",
            "initials": "LMPP",
            "lastname": "do Nascimento"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Dalila C A",
            "initials": "DCA",
            "lastname": "Pav\u00e3o"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Anna P S",
            "initials": "APS",
            "lastname": "Pinheiro"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Andreza H O",
            "initials": "AHO",
            "lastname": "Pinheiro"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Mar\u00edlia C B",
            "initials": "MCB",
            "lastname": "Alves"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "K\u00edssila M M M",
            "initials": "KMMM",
            "lastname": "Ferraro"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Larisse F Q",
            "initials": "LFQ",
            "lastname": "Aires"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Luana G",
            "initials": "LG",
            "lastname": "Dias"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Mayara M M",
            "initials": "MMM",
            "lastname": "Machado"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Michaelle J D",
            "initials": "MJD",
            "lastname": "Serr\u00e3o"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Raphaella R",
            "initials": "RR",
            "lastname": "Gomes"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Sara M P",
            "initials": "SMP",
            "lastname": "de Moraes"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Gabriella M G",
            "initials": "GMG",
            "lastname": "Moura"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Adriana M B",
            "initials": "AMB",
            "lastname": "de Sousa"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Gabriela C L",
            "initials": "GCL",
            "lastname": "Pontes"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Railana D F P",
            "initials": "RDFP",
            "lastname": "Carvalho"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Cristiane T C",
            "initials": "CTC",
            "lastname": "Silva"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Guilherme",
            "initials": "G",
            "lastname": "Lemes"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1, Bel\u00e9m, PA, Brazil.",
            "firstname": "Bruna",
            "initials": "B",
            "lastname": "da C G Diniz"
        },
        {
            "affiliation": "Medical School, Medical Science Institute, Federal University of Par\u00e1/UFPA, Bel\u00e9m, PA, Brazil.",
            "firstname": "Aurimery G",
            "initials": "AG",
            "lastname": "Chermont"
        },
        {
            "affiliation": "Medical School, Medical Science Institute, Federal University of Par\u00e1/UFPA, Bel\u00e9m, PA, Brazil.",
            "firstname": "Kellen F S",
            "initials": "KFS",
            "lastname": "de Almeida"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Pronto Socorro Municipal M\u00e1rio Pinotti's Hospital, Bel\u00e9m, PA, Brazil.",
            "firstname": "Salma B",
            "initials": "SB",
            "lastname": "Saraty"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Pronto Socorro Municipal M\u00e1rio Pinotti's Hospital, Bel\u00e9m, PA, Brazil.",
            "firstname": "Mary L F",
            "initials": "MLF",
            "lastname": "Maia"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Department of Pediatrics, Pronto Socorro Municipal M\u00e1rio Pinotti's Hospital, Bel\u00e9m, PA, Brazil.",
            "firstname": "Miriam R C",
            "initials": "MRC",
            "lastname": "Lima"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Departament of Pediatrics, Funda\u00e7\u00e3o Hospital das Cl\u00ednicas Gaspar Viana, Bel\u00e9m, PA, Brazil.",
            "firstname": "Patricia B",
            "initials": "PB",
            "lastname": "Carvalho"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Departament of Pediatrics, Funda\u00e7\u00e3o Hospital das Cl\u00ednicas Gaspar Viana, Bel\u00e9m, PA, Brazil.",
            "firstname": "Renata",
            "initials": "R",
            "lastname": "de B Braga"
        },
        {
            "affiliation": "Division of Pediatric Intensive Care, Departament of Pediatrics, Funda\u00e7\u00e3o Hospital das Cl\u00ednicas Gaspar Viana, Bel\u00e9m, PA, Brazil.",
            "firstname": "Kathia",
            "initials": "K",
            "lastname": "de O Harada"
        },
        {
            "affiliation": "Instituto Evandro Chagas, Virology Section, Health Surveillance Secretariat, Brazilian Ministry of Health, Ananindeua, PA, Brazil.",
            "firstname": "Maria C A",
            "initials": "MCA",
            "lastname": "Justino"
        },
        {
            "affiliation": "Division of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Gleice",
            "initials": "G",
            "lastname": "Clemente"
        },
        {
            "affiliation": "Division of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Maria Teresa",
            "initials": "MT",
            "lastname": "Terreri"
        },
        {
            "affiliation": "Pharmaceutical Science Post-Graduation Program and Neuroscience and Cell Biology Graduate Program, Health Science Institute, Federal University of Par\u00e1/UFPA, Bel\u00e9m, PA, Brazil.",
            "firstname": "Marta C",
            "initials": "MC",
            "lastname": "Monteiro"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1038/s41598-024-55065-x\n10.15585/mmwr.mm7107e4\n10.1016/j.lana.2022.100272\n10.1016/j.ijid.2020.11.163\n10.6061/clinics/2020/e2209\n10.1097/CCM.0000000000005232\n10.1001/jama.2021.2091\n10.1016/j.jiph.2020.12.010\n10.1097/PCC.0000000000000558\n10.1097/CCM.0b013e31828a2bbd\n10.1542/peds.2021-052888B\n10.1097/PCC.0000000000002198\n10.1097/PCC.0000000000001191\n10.1007/s00134-017-4920-z\n10.1097/PCC.0000000000003147\n10.1016/j.kint.2020.02.010\n10.1164/rccm.201804-0692OC\n10.4187/respcare.07937\n10.1136/bmj.m3249\n10.1016/j.jpeds.2020.05.006\n10.1016/S2352-4642(21)00134-6\n10.1186/s12879-022-07200-0\n10.1007/s13312-021-2244-0\n10.1007/s13312-021-2196-4\n10.7326/M20-6306\n10.1016/S2214-109X(20)30285-0\n10.1016/S2352-4642(21)0016-8\n10.3389/fped.2022.868297\n10.4414/smw.2021.w30105\n10.1097/CCE.0000000000000783\n10.1097/CCM.0b013e3182a84a43",
    "journal": "Scientific reports",
    "keywords": [
        "Child health",
        "Intensive Care Unit",
        "Mortality",
        "Pediatric",
        "Risk factor",
        "SARS-CoV-2 virus"
    ],
    "methods": null,
    "publication_date": "2024-03-07",
    "pubmed_id": "38448485\n35176003\n35599855\n33227520\n32844958\n34387240\n33625505\n33486375\n26492059\n23685639\n34970673\n32032273\n28486385\n28936698\n36661420\n32409237\n30211618\n32788320\n32392288\n32960186\n32407719\n34119027\n35428202\n34176797\n33452767\n33253040\n32622400\n34119026\n35498776\n34843180\n36311557\n24121467",
    "results": null,
    "title": "Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting.",
    "xml": "<Element 'PubmedArticle' at 0x788504885350>"
}