J Pediatr Infect Dis 2023; 18(01): 001-009
DOI: 10.1055/s-0042-1759529
Original Article

Early Short-Term Use of Different Doses of Corticosteroid in Hospitalized Pediatric Patients with Coronavirus Disease 2019 Pneumonia

1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Belgin Gülhan
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Saliha Kanik Yüksek
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Ahmet Yasin Güney
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Tuğba Erat
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Aysun Yahşi
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Ömer Güneş
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Latife Güder
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Özlem Mustafaoğlu
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Pınar Bayraktar
1   Pediatric Infectious Diseases Unit, Ankara City Hospital, Ankara, Türkiye
,
Fatih Üçkardeş
2   Adıyaman University Department of Biostatistics and Medical Informatics, Adıyaman, Türkiye
,
Serhat Emeksiz
3   Department of Pediatric Intensive Care Unit, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Türkiye
,
Gülsüm İclal Bayhan
4   Pediatric Infectious Diseases Unit, Ankara City Hospital, Yildirim Beyazit University, Ankara, Türkiye
,
Aslınur Özkaya Parlakay
4   Pediatric Infectious Diseases Unit, Ankara City Hospital, Yildirim Beyazit University, Ankara, Türkiye
› Author Affiliations

Abstract

Objective Encouraged by reports of favorable outcomes following the use of corticosteroids in patients with moderate-to-severe coronavirus 2019 (COVID-19) pneumonia, we aimed to present our experience with early short-term corticosteroid use at our center in pediatric patients with COVID-19 pneumonia.

Methods One hundred and twenty-nine pediatric patients were included in the study. Patients were divided into four groups according to the type and dose of corticosteroids given: Group 1 (those receiving dexamethasone 0.15 mg/kg/d); Group 2 (those receiving methylprednisolone 1 mg/kg/d); Group 3 (those receiving methylprednisolone 2 mg/kg/d); and Group 4 (those receiving pulse methylprednisolone 10–30 mg/kg/d).

Results Of 129 patients, 19 (14.7%) patients were assigned to Group 1, 30 (23.3%) patients to Group 2, 30 (23.3%) patients to Group 3, and 50 (38.8%) patients to Group 4. Thirty-two (24.8%) patients were followed in the pediatric intensive care unit (PICU), of whom 13 (10%) required mechanical ventilation, and 7 (%5.4) died. In Group 4, the hospitalization length was significantly longer than in other groups (p < 0.001, p < 0.001). No significant difference was found among the groups in terms of mortality (p = 0.15). The most common comorbidity was obesity (33%). A significant association was found between the presence of comorbidity and mortality (p < 0.001). All patients who died had an underlying disease. Cerebral palsy was the most common underlying disease among the patients who died. Worsening of lymphopenia was significant in patients with severe COVID-19 pneumonia at the time of transfer to the PICU (p = 0.011).

Conclusion Although children usually have a milder course of COVID-19 than adults, underlying diseases and obesity increase the severity of disease manifestations also in children. Further studies are needed to define the exact role of corticosteroids in COVID-19 patients.



Publication History

Received: 15 July 2022

Accepted: 26 October 2022

Article published online:
01 December 2022

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