In a recent study posted to the Research Square* preprint server, researchers described coronavirus disease 2019 (COVID-19) infection in technology-dependent children.
Technology-dependent children are defined as children who need a medical device to compensate for the loss of an essential bodily function and require ongoing nursing care to evade further disability or mortality. Various studies have reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children with technology-dependence (TD) are at a higher risk of COVID-19 severity or related hospitalization.
Study: SARS-CoV-2 infection in technology-dependent children: a multicenter case series. Image Credit: Jsnow my world / Shutterstock
About the study
In the present study, the researchers characterized the clinical course and outcomes in TD children who are hospitalized due to SARS-CoV-2 infection.
The team took into account 17 pediatric hospitals across Canada, Iran, and Costa Rica that had children aged up to 17 years admitted between 1 February 2020 and 31 May 2021 with a SARS-CoV-2 diagnosis. The team defined TD as the baseline requirement for either one or more of the following: (1) tube feeds; (2) supplemental oxygen; (3) tracheostomy; (4) non-invasive ventilation (NIV) with either bilevel or continuous airway pressure; (5) mechanical ventilation (MV); or (6) intravenous nutrition before admission.
The team also collected demographic data, hospital admission reasons, comorbidities including any type of TD, clinical courses including interventions for SARS-CoV-2 infection, and outcomes. For example, reasons for admission could include COVID-19 admission due to a non-COVID-19 indication while COVID-19 delayed the admission, or COVID-19 diagnosis, which did not lead to hospital admission.
Results
The study results showed that a total of 334 children were hospitalized due to COVID-19, while 23 were hospitalized for an indication other COVID-19, and 334 had an incidental COVID-19 infection. Approximately 42 children reported TD, among which 22 were dependent only on a feeding tube, nine needed only supplemental oxygen, three needed feeder tubes as well as supplemental oxygen, two had a tracheostomy but did not require ventilation, four required non-invasive ventilation, and two were mechanically ventilated before hospitalization.
Among the 42 TD children, three reported incidental SARS-CoV-2 infection. Two of the children having end-stage underlying conditions succumbed due to respiratory failure on the second day of hospitalization after being shifted to comfort care. For the rest of the 37 TD cases, 43% needed respiratory support higher than that of baseline due to COVID-19 while 5% did not. Out of the 43% that required support, 16% needed only supplemental oxygen, 22% needed new NIV, and 5% required new MV.
Conclusion
The study findings showed that children with TD are at a significantly higher risk of COVID-19 hospitalization. However, children who were not suffering from end-stage chronic conditions were discharged from the hospital. Therefore, the researchers believe that the medical community should recognize the susceptibility of TD individuals and ensure timely administration of COVID-19 vaccination among this population.
*Important notice
Research Square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.