Caracterización clínico-epidemiológica de pacientes pediátricos con COVID-19 atendidos en un hospital regional de El Salvador
Resumen
OBJETIVO: Describir las características epidemiológicas, clínicas, de laboratorio, imagen y tratamiento de casos pediátricos de COVID-19, confirmados por reacción en cadena de polimerasa-transcriptasa reversa (RT PCR) o serología, atendidos en un hospital regional de El Salvador.
MATERIALES Y MÉTODOS: Estudio transversal y descriptivo de pacientes pediátricos con COVID-19, confirmados con pruebas moleculares o serología atendidos entre el 1 de junio y el 31 de diciembre de 2020. Para asegurar la confidencialidad se asignó un código por paciente.
RESULTADOS: Se estudiaron 72 pacientes entre los que predominó el grupo de 1 a 4 años (n = 25). La media de edad fue de 3.4 años; 28 de sexo femenino y 44 del masculino. Permanecieron asintomáticos 3 pacientes, 37 con síntomas leves, 22 moderados, 4 graves y 6 críticos. Los síntomas más frecuentes fueron: fiebre, hiporexia, adinamia y tos. Los hallazgos de laboratorio de mayor reporte fueron: anemia, linfopenia, deshidrogenasa láctica, proteína C reactiva y velocidad de eritrosedimentación elevadas. En la radiografía de tórax se encontró neumonía en 26 pacientes. Tratamientos más indicados: antibióticos y acetaminofén. Once pacientes requirieron oxígeno suplementario y siete ventilación mecánica. La estancia hospitalaria en menores de 1 año fue del doble con respecto a los otros grupos etarios. Seis pacientes resultaron con síndrome inflamatorio multisistémico. Hubo siete fallecimientos.
CONCLUSIONES: Si bien en la mayoría de los casos el pronóstico fue favorable, algunos pacientes tuvieron enfermedad grave o crítica y fallecieron a pesar de su atención en cuidados intensivos. Para disminuir estos desenlaces se requiere educar a la población a fin de que acuda rápidamente a consulta, fortalecer las competencias clínicas del personal de salud para la identificación oportuna de la enfermedad e incrementar la capacidad instalada de cuidados intensivos ante fenómenos epidemiológicos similares.
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