Factores asociados a hospitalización en cuidados intensivos de pacientes pediátricos contagiados con COVID-19 entre marzo del 2020 y 2023
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Introducción: En diciembre de 2019, se reportó el primer caso de infección por el virus Coronavirus 2 del Síndrome Respiratorio Agudo Grave (SARS-CoV-2) en Wuhan, China. La rápida propagación y la escala de transmisión del virus llevó a la declaración de pandemia en marzo de 2020, resultando en alta mortalidad global. El objetivo de este estudio fue describir factores asociados a la hospitalización en UCIP en pacientes pediátricos con COVID-19 entre marzo de 2020 y mayo de 2023. Materiales y Métodos: Estudio de corte transversal en menores de 18 años con SARS-CoV-2 confirmado (PCR o antígeno) hospitalizados en un centro de alta complejidad del suroccidente colombiano. Resultados: Se incluyeron 419 pacientes hospitalizados (>24 horas), con una mediana de edad de 4 años (RIQ 1-10.3). La mayoría fueron hombres (52.7%). Los antecedentes más frecuentes fueron: hospitalizaciones previas por enfermedad respiratoria (23.6%) y neoplasia con manejo inmunosupresor (15.1%). Setenta pacientes requirieron UCIP (16.7%); los síntomas más frecuentes al ingreso fueron fiebre (52.8%) y dificultad respiratoria (47.1%). Los factores asociados al ingreso a UCIP fueron: coinfección bacteriana (OR 4.66 IC95% 1.69-12.9), falla respiratoria aguda (OR 2.77 IC95% 1.33-5.76) y choque (OR 5.50 IC95% 1.19-26). Hubo nueve fallecimientos en UCIP. Discusión: Aunque el COVID-19 pediátrico suele ser leve, ciertos factores predisponen a evolución severa y requerimiento de cuidados intensivos. La identificación temprana de estos factores es clave para la estratificación del riesgo y decisiones terapéuticas oportunas.
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