{"doi":"10.1371/journal.pone.0283037","title":"Relationship between sociodemographic, clinical, and laboratory characteristics and severity of COVID-19 in pediatric patients","abstract":"COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1-10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2-6.5), breathing difficulty OR: 3.4 (CI95%: 1.4-8.2), vomiting OR: 3.3 (CI95%: 1.4-7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9-16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.","journal":"PLOS ONE","year":2024,"id":10329,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.0414,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-05-07","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":86538,"name":"Adriana Asturizaga","orcid":null,"position":1,"is_corresponding":false},{"id":86539,"name":"Nelson Villca","orcid":null,"position":2,"is_corresponding":false},{"id":86540,"name":"Ramiro Cabrera","orcid":null,"position":3,"is_corresponding":false},{"id":86541,"name":"Raul Copana-Olmos","orcid":"0000-0002-3084-7611","position":4,"is_corresponding":false},{"id":86542,"name":"Vladimir Aguilera-Avendano","orcid":null,"position":5,"is_corresponding":false},{"id":86543,"name":"Claudia Estrada-Villarroel","orcid":null,"position":6,"is_corresponding":false},{"id":86544,"name":"Mariel Andrea Forest-Yepez","orcid":"0000-0001-9000-3990","position":7,"is_corresponding":false},{"id":86545,"name":"Marcia Torrez-Santos","orcid":null,"position":8,"is_corresponding":false},{"id":86546,"name":"Adela Felipa Magne-Calle","orcid":null,"position":9,"is_corresponding":false},{"id":86547,"name":"Maria Ofelia Foronda-Rios","orcid":null,"position":10,"is_corresponding":false},{"id":86548,"name":"Liz Malena Pena-Helguero","orcid":null,"position":11,"is_corresponding":false},{"id":86549,"name":"Monica Montalvo","orcid":null,"position":12,"is_corresponding":false},{"id":86550,"name":"Delina Torrez","orcid":null,"position":13,"is_corresponding":false},{"id":86551,"name":"Mirna Toco","orcid":null,"position":14,"is_corresponding":false},{"id":86552,"name":"Miguel Cespedes","orcid":null,"position":15,"is_corresponding":false},{"id":86553,"name":"Ingrid Davalos","orcid":null,"position":16,"is_corresponding":false},{"id":86554,"name":"Natalie M. 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