BMJ Paediatrics Open (Oct 2022)

Paediatric COVID-19 mortality: a database analysis of the impact of health resource disparity

  • ,
  • Nick Daneman,
  • John Marshall,
  • Vinod Kumar,
  • Aasiyah Rashan,
  • Jérôme Dimet,
  • Sylvain Diamantis,
  • John F Fraser,
  • Dominique Deplanque,
  • Anne Conrad,
  • François Lellouche,
  • Heidi Gruner,
  • Detlef Kindgen-Milles,
  • Agnes Meybeck,
  • Maxime Hentzien,
  • Clotilde Allavena,
  • André Cabié,
  • Firouzé Bani-Sadr,
  • Patrick Rossignol,
  • Arjen M Dondorp,
  • Rashan Haniffa,
  • Harald Vonkeman,
  • Lionel Piroth,
  • Mathieu Blot,
  • Yaseen Arabi,
  • Marie-Pierre Debray,
  • François Angoulvant,
  • Marc Leone,
  • Maria Zambon,
  • Florentia Kaguelidou,
  • Marc Lambert,
  • Olivier Lairez,
  • Tom Solomon,
  • Carrol Gamble,
  • Laura Marsh,
  • David Richardson,
  • Christiana Kartsonaki,
  • Philippe Jouvet,
  • Asgar Rishu,
  • Eman Al Qasim,
  • Rachael Parke,
  • Srinivas Murthy,
  • Alistair Nichol,
  • Calum Semple,
  • Colin McArthur,
  • Gail Carson,
  • Jake Dunning,
  • Laura Merson,
  • Peter Horby,
  • David Maslove,
  • Nadia Malik,
  • Stephen R Knight,
  • Annelies Verbon,
  • Oana Sândulescu,
  • Patrick Archambault,
  • Paul McNally,
  • Marlene Murris,
  • Aurore Bousquet,
  • Kenneth A McLean,
  • Hugues Cordel,
  • Marc Fabre,
  • Laurence Bouillet,
  • Melissa Parker,
  • Xavier Duval,
  • Amanda Corley,
  • James Lee,
  • Kusum Menon,
  • Christian Rabaud,
  • Paul Klenerman,
  • Jean-François Timsit,
  • Jennifer Lee,
  • Nicolas Terzi,
  • Saad Nseir,
  • Gwenhaël Colin,
  • Steve Webb,
  • Kalynn Kennon,
  • Caroline Mudara,
  • Diana Hernández,
  • Yazdan Yazdanpanah,
  • Elias Iosifidis,
  • Emmanuel Roilides,
  • Yi Lin Lee,
  • Pieter Depuydt,
  • Jean-François Payen,
  • Ana Martins,
  • Samreen Ijaz,
  • Meera Chand,
  • Wei Shen Lim,
  • Bruno Levy,
  • Eric D'ortenzio,
  • Jean-Charles Preiser,
  • Pierre Delobel,
  • Claudia Figueiredo-Mello,
  • Jaques Sztajnbok,
  • Ana Freitas Ribeiro,
  • Tiphaine Goulenok,
  • Bronner P Gonçalves,
  • Arnaud Scherpereel,
  • Chloe Donohue,
  • Carlo Giaquinto,
  • Karolina Nowicka,
  • Adrien Auvet,
  • Debby Bogaert,
  • Elisabeth Botelho-Nevers,
  • Amandine Gagneux-Brunon,
  • Merce Jourdain,
  • Anne McCarthy,
  • Todd C Lee,
  • António Mesquita,
  • Sue Smith,
  • Jia Wei,
  • Jenny Lennon,
  • Antoine Khalil,
  • Nathalie Pansu,
  • Victor Fomin,
  • Audrey Barrelet,
  • Christophe Fraser,
  • Daniel Munblit,
  • Robert A Fowler,
  • William Greenhalf,
  • François-Xavier Lescure,
  • Nicolas Carlier,
  • Saye Khoo,
  • Riinu Pius,
  • Lisa Norman,
  • Louise Sigfrid,
  • Sophie Halpin,
  • Clare Jackson,
  • Antonia Ho,
  • Andrew Dagens,
  • Thomas Flament,
  • Julie Mankikian,
  • Romain Basmaci,
  • Peter Openshaw,
  • Mary Copland,
  • Brenda Reeve,
  • William Dechert,
  • Patricia Lizotte,
  • Felwa Bin Humaid,
  • Tom Fletcher,
  • Adrien Lemaignen,
  • Pierre Tattevin,
  • Christelle Delmas,
  • Hélène Espérou,
  • Claire Lévy-Marchal,
  • Olivier Picone,
  • Jeanne Sibiude,
  • Cecile Yelnik,
  • Olivia V Swann,
  • Michelle Girvan,
  • Piero L Olliaro,
  • Beatrice Alex,
  • Benjamin Bach,
  • Alexander J Mentzer,
  • Mahdad Noursadeghi,
  • Shona C Moore,
  • Massimo Palmarini,
  • Georgios Pollakis,
  • Vanessa Sancho-Shimizu,
  • Shiranee Sriskandan,
  • David Stuart,
  • Charlotte Summers,
  • Ryan S Thwaites,
  • Hayley Hardwick,
  • Wilna Oosthuyzen,
  • Fiona Griffiths,
  • Jo Dalton,
  • Egle Saviciute,
  • Stephanie Roberts,
  • Janet Harrison,
  • Marie Connor,
  • Gary Leeming,
  • Ross Hendry,
  • Victoria Shaw,
  • Jade Ghosn,
  • Lucille Blumberg,
  • Nicolas Benech,
  • James Scott-Brown,
  • Odile Launay,
  • Todd Karsies,
  • Yoan Lavie-Badie,
  • Minh Le,
  • Elise Artaud-Macari,
  • Mylène Maillet,
  • Huda Alfoudri,
  • Djura Piersma,
  • Didier Laureillard,
  • Graham S. Cooke,
  • Nicholas Sedillot,
  • Anne-Sophie Boureau,
  • Tony Trapani,
  • Laurent Abel,
  • Samuel Hinton,
  • Sally Shrapnel,
  • Heidi Dalton,
  • Guillaume Martin-Blondel,
  • Valérie Garrait,
  • Isabelle Delacroix,
  • Samantha Lissauer,
  • Malte Kohns Vasconcelos,
  • Oleksa Rewa,
  • Erlina Burhan,
  • Sara Machado,
  • Jean-Benoît Arlet,
  • Raphaël Borie,
  • Kévin Bouiller,
  • Vincent Langlois,
  • Mélanie Roriz,
  • Mical Paul,
  • Vincent Dubée,
  • Erwan L'her,
  • Michael Rose,
  • Luis Felipe Reyes,
  • Anna Beltrame,
  • Stéphanie Fry,
  • Andrew Udy,
  • Laurent Plantier,
  • Jean-Christophe Goffard,
  • Denis Malvy,
  • Nina Jamieson,
  • Irfan Khan,
  • François Dubos,
  • Jean-Sébastien Hulot,
  • Paola Rodari,
  • Paul Campbell,
  • Abigail Beane,
  • Cécile Tromeur,
  • Paul Loubet,
  • Marina Esposito-Farèse,
  • France Mentré,
  • Valérie Gaborieau,
  • Anne-Marie Guerguerian,
  • Cécile Goujard,
  • Vincent Thibault,
  • Rodrigo Díaz,
  • Patricia Gordon,
  • Sadie Kelly,
  • Bertrand Dussol,
  • Simon Forsyth,
  • Marion Schneider,
  • Nathalie Gault,
  • Marielle Buisson,
  • Yves Levy,
  • Prasan Kumar Panda,
  • Marjolein Brusse-Keizer,
  • Carine Roy,
  • Walter Picard,
  • Tom Drake,
  • Paul Tierney,
  • Olivier Sanchez,
  • Antoine Kimmoun,
  • David Thomson,
  • Nathan Peiffer-Smadja,
  • Julien Poissy,
  • Lila Bouadma,
  • Bruno Lina,
  • Maude Bouscambert,
  • Alexandre Gaymard,
  • Gilles Peytavin,
  • Jeremie Guedj,
  • Claire Andrejak,
  • Cedric Laouenan,
  • Anissa Chair,
  • Samira Laribi,
  • Marie-Capucine Tellier,
  • Sandrine Couffin-Cadiergues,
  • Soizic Le Mestre,
  • Ventzislava Petrov-Sanchez,
  • Alpha Diallo,
  • NoéMie Mercier,
  • Sarah Tubiana,
  • Marion Noret,
  • Oriane Puechal,
  • Caroline Semaille,
  • Patrick Imbert,
  • Jonathan Remppis,
  • Emmanuelle Mercier,
  • Rui Pereira,
  • Sylvie Van Der Werf,
  • Waasila Jassat,
  • Arsene Kpangon,
  • Dominique Luton,
  • Sophie Mahy,
  • Pierre-Adrien Bolze,
  • Sarah Moore,
  • Adrienne Chan,
  • Raphael Favory,
  • Daniel Mathieu,
  • Andrea Angheben,
  • Andrea Rossanese,
  • Matthew Hall,
  • Johann Auchabie,
  • Mohammed Quraishi,
  • Katharina Weil,
  • Hanna Renk,
  • Hans Martin Bosse,
  • Christophe Rapp,
  • Vincent Peigne,
  • Tae Song,
  • Dewi Guellec,
  • Mark G. Pritchard,
  • Adrian Streinu-Cercel,
  • Christl A Donnelly,
  • François Goehringer,
  • Elodie Curlier,
  • Catherine Chirouze,
  • Stéphane Jaureguiberry,
  • Ary Serpa Neto,
  • Jose Andres Calvache,
  • Laurent Bitker,
  • Hodane Yonis,
  • Neerusha Kaisbain,
  • Coline Jaud-Fischer,
  • Laurent Mandelbrot,
  • Jérémie Pasquier,
  • Juliette Patrier,
  • Gianluigi Li Bassi,
  • Sheryl Ann Abdukahil,
  • Jia Shyi Loy,
  • Filipe Cardoso,
  • Diptesh Aryal,
  • Polina Bugaeva,
  • Evert-Jan Wils,
  • Stephanie Yerkovich,
  • Julie Chas,
  • Thushan de Silva,
  • Ruth Lyons,
  • Murray Wham,
  • Sara Clohisey,
  • Seán Keating,
  • Thibault Chiarabini,
  • Agnes Sommet,
  • Hugues Aumaître,
  • Sylvie LeGac,
  • Sarah E McDonald,
  • Jeanne Truong,
  • Camille Couffignal,
  • Anne-Hélène Boivin,
  • Timo Brandenburger,
  • Diane Descamps,
  • Tala Al-Dabbous,
  • Mark Joseph,
  • Hwa Jin Cho,
  • Desy Rusmawatiningtyas,
  • Muhammad Rayhan,
  • Christel Arnold-Day,
  • Navy Lolong,
  • Ernita Akmal,
  • Menaldi Rasmin,
  • Daniel Marino,
  • Neurinda Permata Kusumastuti,
  • Stéphane Lasry,
  • Amanda Rojek,
  • Sebastien Preau,
  • Jean-Marie Turmel,
  • Nowneet Kumar Bhat,
  • Cynthia Braga,
  • Pavan Kumar Vecham,
  • Benoit Thill,
  • Karine Faure,
  • Denis Garot,
  • Grégory Corvaisier,
  • Elsa Nyamankolly,
  • Joshua Solomon,
  • Emma Clarke,
  • Patricia Fontela,
  • Eva Geraud,
  • Eva Miranda Marwali,
  • Aria Kekalih,
  • Saptadi Yuliarto,
  • Dyah Kanya Wati,
  • Ivy Cerelia Valerie,
  • Maureen Masha,
  • Jolanta Popielska,
  • Anca Streinu-Cercel,
  • Mohan Dass Pathmanathan,
  • Barbara Wanjiru Citarella,
  • Heidi Jean Dalton,
  • Nurul Najmee Abdulkadir,
  • Lara Absil,
  • Subhash Acharya,
  • Diana Adrião,
  • Younes Ait Tamlihat,
  • Kévin Alexandre,
  • Kazali Enagnon Alidjnou,
  • Nathalie Allou,
  • Rita Alves,
  • Joana Alves Cabrita,
  • Maria Amaral,
  • Nur Amira,
  • Phoebe Ampaw,
  • Séverine Ansart,
  • Sivanesen Anthonidass,
  • Carlos Alexandre Brito,
  • Ardiyan Apriyana,
  • Carolline Araujo,
  • Muhammad Ashraf,
  • Jean Baptiste Assie,
  • Amirul Asyraf,
  • Anika Atique,
  • AM Udara Attanyake,
  • Laurène Azemar,
  • Cecile Azoulay,
  • Delphine Bachelet,
  • Claudine Badr,
  • J. Kenneth Baillie,
  • Nazreen Abu Bakar,
  • Mohanaprasanth Balakrishnan,
  • Valeria Balan,
  • Renata Barbalho,
  • Wendy S. Barclay,
  • Saef Umar Barnett,
  • Marie Bartoli,
  • Joaquín Baruch,
  • Muhammad Fadhli Basri,
  • Jules Bauer,
  • Diego Fernando Rincon,
  • Alexandra Bedossa,
  • Ker Hong Bee,
  • Husna Begum,
  • Sylvie Behilill,
  • Albertus Beishuizen,
  • Marine Beluze,
  • Lionel Eric Benjiman,
  • Dehbia Benkerrou,
  • Delphine Bergeaud,
  • José Luis Sobrino,
  • Giulia Bertoli,
  • Simon Bessis,
  • Sybille Bevilcaqua,
  • Karine Bezulier,
  • Krishna Bhavsar,
  • Farah Nadiah Bidin,
  • Mohd Nazlin Kamarudin,
  • François Bissuel,
  • Jonathan Bitton,
  • Laetitia Bodenes,
  • Isabela Bolaños,
  • François Bompart,
  • Diogo Borges,
  • Olivier Bouchaud,
  • Sabelline Bouchez,
  • Dounia Bouhmani,
  • Damien Bouhour,
  • Camile Bouisse,
  • Jason Bouziotis,
  • Bianca Boxma,
  • Marielle Boyer-Besseyre,
  • Fernando Augusto Bozza,
  • Axelle Braconnier,
  • Kathy Brickell,
  • Aidan Burrell,
  • Ingrid G Bustos,
  • Denis Butnaru,
  • Eder Caceres,
  • Cyril Cadoz,
  • Rui Caetano Garcês,
  • Valentine Campana,
  • Pauline Caraux-Paz,
  • Chiara Simona Cardellino,
  • Sofia Cardoso,
  • Filipa Cardoso,
  • Thierry Carmoi,
  • Marie-Christine Carret,
  • François Martin Carrier,
  • Maire-Laure Casanova,
  • Mariana Cascão,
  • José Casimiro,
  • Nidyanara Castanheira,
  • Guylaine Castor-Alexandre,
  • François-Xavier Catherine,
  • Paolo Cattaneo,
  • Roberta Cavalin,
  • Minerva Cervantes-Gonzalez,
  • Catherine Chakveatze,
  • Christelle Chantalat Auger,
  • Jean-Marc Chapplain,
  • Anjellica Chen,
  • Matthew Pellan Cheng,
  • Antoine Cheret,
  • Julian Chica,
  • Suresh Kumar Chidambaram,
  • Leong Chin Tho,
  • Bernard Cholley,
  • Marie-Charlotte Chopin,
  • Ting Soo Chow,
  • Hiu Jian Chua,
  • Jonathan Chua,
  • Alexandra Coelho,
  • Megan Coles,
  • Pamela Combs,
  • Sabine Cornelis,
  • Alexander Daniel Cornet,
  • Arianne Joy Corpuz,
  • Emma Costigan,
  • Roxane Courtois,
  • Stéphanie Cousse,
  • Rachel Cregan,
  • Sabine Croonen,
  • Claudina Cruz,
  • Juan Luis Bermúdez,
  • Jaime Cruz Rojo,
  • Paula Custodio,
  • Ana Silva Filipe,
  • Charlene Da Silveira,
  • Juliana Damas,
  • Corinne Daniel,
  • Emmanuelle A Dankwa,
  • Jorge Dantas,
  • Etienne De Montmollin,
  • Rafael Freitas França,
  • Peter de Vries,
  • Jillian Deacon,
  • Alexa Debard,
  • Nathalie DeCastro,
  • Lauren Deconninck,
  • Romain Decours,
  • Eve Defous,
  • Eric Delaveuve,
  • Karen Delavigne,
  • Corine Delsing,
  • Elisa Demonchy,
  • Emmanuelle Denis,
  • Mathilde Desvallées,
  • Santi Dewayanti,
  • Pathik Dhanger,
  • André Dias,
  • Kévin Didier,
  • Jean-Luc Diehl,
  • Wim Dieperink,
  • Vincent Dinot,
  • Fara Diop,
  • Alphonsine Diouf,
  • Yael Dishon,
  • Félix Djossou,
  • Annemarie B. Docherty,
  • Maria Donnelly,
  • Céline Dorival,
  • James Joshua Douglas,
  • Nathalie Dournon,
  • Murray Dryden,
  • Claudio Duarte Fonseca,
  • Alexandre Ducancelle,
  • Paul Dunand,
  • Sim Choon Ean,
  • Mohammed El Sanharawi,
  • Brigitte Elharrar,
  • Philippine Eloy,
  • Isabelle Enderle,
  • Chan Chee Eng,
  • Ilka Engelmann,
  • Vincent Enouf,
  • Olivier Epaulard,
  • Martina Escher,
  • Catarina Espírito Santo,
  • João Estevão,
  • Manuel Etienne,
  • Nadia Ettalhaoui,
  • Mirjam Evers,
  • Isabelle Fabre,
  • Amna Faheem,
  • Arabella Fahy,
  • Cameron J. Fairfield,
  • Pedro Faria,
  • Ahmed Farooq,
  • Hanan Fateena,
  • Jorge Fernandes,
  • Marília Andreia Fernandes,
  • François-Xavier Ferrand,
  • Eglantine Ferrand Devouge,
  • Joana Ferrão,
  • Mário Ferraz,
  • Bernardo Ferreira,
  • Nicolas Ferriere,
  • Céline Ficko,
  • Clara Flateau,
  • Tatiana Fonseca,
  • Erwan Fourn,
  • Robert A. Fowler,
  • Marcela Vieira Freire,
  • Rostane Gaci,
  • Jean-Charles Gagnard,
  • Yasmin Gani,
  • Noelia García Barrio,
  • Esteban Garcia-Gallo,
  • Louis Gerbaud Morlaes,
  • Nuno Germano,
  • Jess Gibson,
  • Tristan Gigante,
  • Morgane Gilg,
  • Guillermo Giordano,
  • Valérie Gissot,
  • Daniel Glikman,
  • Petr Glybochko,
  • Geraldine Goco,
  • Siri Goepel,
  • Jin Yi Goh,
  • Marie Gominet,
  • Bronner P. Gonçalves,
  • Isabelle Gorenne,
  • Laure Goubert,
  • Pascal Granier,
  • Christopher A. Green,
  • Courtney Greene,
  • Segolène Greffe,
  • Albert Groenendijk,
  • Anja Grosse Lordemann,
  • Yusing Gu,
  • Martin Guego,
  • Daniela Guerreiro,
  • Romain Guery,
  • Anne Guillaumot,
  • Laurent Guilleminault,
  • Thomas Guimard,
  • Marieke Haalboom,
  • Daniel Haber,
  • Hannah Habraken,
  • Ali Hachemi,
  • Nadir Hadri,
  • Fakhir Haidri,
  • Ansley Hamer,
  • Rebecca Hamidfar,
  • Lim Yuen Han,
  • Kok Wei Hao,
  • Ewen M. Harrison,
  • Lars Heggelund,
  • Astarini Hidayah,
  • Rupert Higgins,
  • Hikombo Hitoto,
  • Yi Bin Ho,
  • Alexandre Hoctin,
  • Isabelle Hoffmann,
  • Wei Han Hoh,
  • Ikram Houas,
  • Catherine L. Hough,
  • Jimmy Ming-Yang Hsu,
  • Arfan Ikram,
  • Hajnal-Gabriela Illes,
  • Hugo Inácio,
  • Yun Sii Ing,
  • Sarah Isgett,
  • Tiago Isidoro,
  • Nadiah Ismail,
  • Margaux Isnard,
  • Danielle Jaafar,
  • Salma Jaafoura,
  • Julien Jabot,
  • Pierre Jaquet,
  • Florence Jego,
  • Anilawati Mat Jelani,
  • Ong Yiaw Joe,
  • Cédric Joseph,
  • Swosti Joshi,
  • Dafsah Juzar,
  • Ouifiya Kafif,
  • Thavamany Kaleesvran,
  • Sabina Kali,
  • Muhammad Aisar Kamaluddin,
  • Zul Amali Kamaruddin,
  • Nadiah Kamarudin,
  • Kong Yeow Kang,
  • Pratap Karpayah,
  • Anant Kataria,
  • Kevin Katz,
  • Yvelynne Kelly,
  • Younes Kerroumi,
  • Sharma Keshav,
  • Coralie Khan,
  • Quratul Ain Khan,
  • Sushil Khanal,
  • Abid Khatak,
  • Ryan Khoo,
  • Denisa Khoo,
  • Khor How Kiat,
  • Peter Kiiza,
  • Rob Klont,
  • Gry Kloumann Bekken,
  • Robin Kobbe,
  • Chamira Kodippily,
  • Malte Kohns Vasconcelos,
  • Vinothini Krishnan,
  • Ganesh Kumar,
  • Bharath Kumar Vijayaraghavan,
  • Demetrios Kutsogiannis,
  • Marie Lachatre,
  • Marie Lacoste,
  • Marie Lagrange,
  • Fabrice Laine,
  • Antonio Lalueza,
  • Marie Langelot-Richard,
  • Marina Lanza,
  • Delphine Lariviere,
  • Andy Law,
  • Teresa Lawrence,
  • Clément Le Bihan,
  • Cyril Le Bris,
  • Georges Le Falher,
  • Lucie Le Fevre,
  • Quentin Le Hingrat,
  • Marion Le Maréchal,
  • Gwenaël Le Moal,
  • Vincent Le Moing,
  • Hervé Le Nagard,
  • Paul Le Turnier,
  • Ema Leal,
  • Marta Leal Santos,
  • Heng Gee Lee,
  • Biing Horng Lee,
  • Laurent Lefebvre,
  • Bénédicte Lefebvre,
  • Benjamin Lefèvre,
  • Jean-Daniel Lelievre,
  • Véronique Lemee,
  • Anthony Lemeur,
  • Ha Sha Lene,
  • Quentin Lepiller,
  • Olivier Lesens,
  • Mathieu Lesouhaitier,
  • Geoffrey Liegeon,
  • Kah Chuan Lim,
  • Lim Lina,
  • Guillaume Lingas,
  • Sylvie Lion-Daolio,
  • Marine Livrozet,
  • Leong Chee Loon,
  • Diogo Lopes,
  • Anthony L. Loschner,
  • Bouchra Loufti,
  • Guillame Louis,
  • Lee Lee Low,
  • Marije Lowik,
  • Jean Christophe Lucet,
  • Carlos Lumbreras Bermejo,
  • Liem Luong,
  • Oryane Mabiala,
  • Moïse Machado,
  • Gabriel Macheda,
  • Hashmi Madiha,
  • Guillermo Maestro de la Calle,
  • Rafael Mahieu,
  • Thomas Maitre,
  • Fernando Maltez,
  • Victoria Manda,
  • Jose M. Mandei,
  • Edmund Manning,
  • Aldric Manuel,
  • Ceila Sant'Ana Malaque,
  • Samuel Markowicz,
  • Celina Turchi Martelli,
  • Martin Martinot,
  • Caroline Martins Rego,
  • Marsilla Marzukie,
  • Sabina Mason,
  • Sobia Masood,
  • Basri Mat Nor,
  • Moshe Matan,
  • Mathieu Mattei,
  • Romans Matulevics,
  • Laurence Maulin,
  • Thierry Mazzoni,
  • Cécile Mear-Passard,
  • Ogechukwu Menkiti,
  • Antoine Merckx,
  • Mayka Mergeay-Fabre,
  • Alison M. Meynert,
  • Vanina Meysonnier,
  • Amina Meziane,
  • Mehdi Mezidi,
  • Céline Michelanglei,
  • Isabelle Michelet,
  • Nor Arisah Misnan,
  • Tahira Jamal Mohamed,
  • Nik Nur Mohamed,
  • Asma Moin,
  • Agostinho Monteiro,
  • Claudia Montes,
  • Lina Morales Cely,
  • Lucia Moro,
  • Hugo Mouquet Ben Morton,
  • Clara Mouton Perrot,
  • Julien Moyet,
  • Ng Yong Muh,
  • Dzawani Muhamad,
  • Jimmy Mullaert,
  • Karl Erik Müller,
  • Himed Musaab,
  • Himasha Muvindi,
  • Gugapriyaa Muyandy,
  • Nadège Neant,
  • Nikita Nekliudov,
  • Raul Neto,
  • Anthony Nghi,
  • Duc Nguyen,
  • Nurul Amani Noordin,
  • Nurul Faten Norharizam,
  • Nurnaningsih Nurnaningsih,
  • Annmarie O'Callaghan,
  • Katie O'Hearn,
  • Agnieszka Oldakowska,
  • Piero L. Olliaro,
  • David S.Y. Ong,
  • Jee Yan Ong,
  • Saijad Orakzai,
  • Claudia Milena Orozco-Chamorro,
  • Linda O'Shea,
  • Siti Zubaidah Othman,
  • Nadia Ouamara,
  • Rachida Ouissa,
  • Eric Oziol,
  • Justine Pages Maïder Pagadoy,
  • Lai Hui Pang,
  • Aurélie Papadopoulos,
  • Bruno Pastene,
  • Christelle Paul,
  • Jorge Paulos,
  • William A. Paxton,
  • Kalaiarasu Peariasamy,
  • Miguel Pedrera Jiménez,
  • Florent Peelman,
  • Ithan D. Peltan,
  • Daniel Perez,
  • Thomas Perpoint,
  • Vincent Pestre,
  • Michele Petrovic,
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DOI
https://doi.org/10.1136/bmjpo-2022-001657
Journal volume & issue
Vol. 6, no. 1

Abstract

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Background The impact of the COVID-19 pandemic on paediatric populations varied between high-income countries (HICs) versus low-income to middle-income countries (LMICs). We sought to investigate differences in paediatric clinical outcomes and identify factors contributing to disparity between countries.Methods The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) COVID-19 database was queried to include children under 19 years of age admitted to hospital from January 2020 to April 2021 with suspected or confirmed COVID-19 diagnosis. Univariate and multivariable analysis of contributing factors for mortality were assessed by country group (HICs vs LMICs) as defined by the World Bank criteria.Results A total of 12 860 children (3819 from 21 HICs and 9041 from 15 LMICs) participated in this study. Of these, 8961 were laboratory-confirmed and 3899 suspected COVID-19 cases. About 52% of LMICs children were black, and more than 40% were infants and adolescent. Overall in-hospital mortality rate (95% CI) was 3.3% [=(3.0% to 3.6%), higher in LMICs than HICs (4.0% (3.6% to 4.4%) and 1.7% (1.3% to 2.1%), respectively). There were significant differences between country income groups in intervention profile, with higher use of antibiotics, antivirals, corticosteroids, prone positioning, high flow nasal cannula, non-invasive and invasive mechanical ventilation in HICs. Out of the 439 mechanically ventilated children, mortality occurred in 106 (24.1%) subjects, which was higher in LMICs than HICs (89 (43.6%) vs 17 (7.2%) respectively). Pre-existing infectious comorbidities (tuberculosis and HIV) and some complications (bacterial pneumonia, acute respiratory distress syndrome and myocarditis) were significantly higher in LMICs compared with HICs. On multivariable analysis, LMIC as country income group was associated with increased risk of mortality (adjusted HR 4.73 (3.16 to 7.10)).Conclusion Mortality and morbidities were higher in LMICs than HICs, and it may be attributable to differences in patient demographics, complications and access to supportive and treatment modalities.