OBJECTIVES Spain has been one of the countries most severely affected by the coronavirus disease 2019. This study aims to describe a series of children admitted to a PICU due to coronavirus disease 2019 infection. DESIGN Prospective observational study. SETTING Tertiary hospital in Madrid, Spain. PATIENTS Children admitted to the PICU with severe acute respiratory syndrome coronavirus 2 (severe acute respiratory syndrome coronavirus 2) infection, from March 1, 2020, to April 15, 2020. INTERVENTIONS Observational study. MEASUREMENTS AND MAIN RESULTS Epidemiologic data, previous clinical characteristics, support therapy needed, imaging tests, laboratory observations on admission, and pharmacologic therapy. Eleven children were admitted to the PICU, with suspected coronavirus disease 2019; the polymerase chain reaction test was positive in seven. The median age was 100.7 months (range, 0.5-162). Five were admitted from the emergency department and two from the ward. The Pediatric Sequential Organ Failure Assessment score was 3 (range, 0-9), and Pediatric Risk of Mortality II score was 4 (range, 0-16). All children were previously healthy except one (allogeneic hematopoietic stem cell transplantation). Respiratory symptoms and fever were prevalent. A chest radiograph led to a pneumonia diagnosis. Not all patients presented with lymphopenia on admission. D-Dimer and ferritin were elevated. All patients needed oxygen therapy through a nasal cannula; five patients received high-flow nasal cannula therapy, which was later substituted with noninvasive ventilation in four. Mechanical ventilation was necessary in two patients on the first day of PICU admission. Two children required mechanical ventilation and inotropic support. Tocilizumab was applied in two intubated children. Also, four children received heparin. No patients died. CONCLUSIONS On the whole, the children were previously healthy and are more than 1 year old. Respiratory symptoms were the leading cause of PICU admission, making respiratory support the principal therapy. Patients requiring mechanical ventilation showed deterioration on the first day of admission. These children seemed to require close monitoring, and multicenter studies are necessary.

中文翻译：

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因严重急性呼吸综合征冠状病毒 2 感染而接受重症监护的儿童：西班牙医院的经验。

目标 西班牙是受 2019 年冠状病毒病影响最严重的国家之一。本研究旨在描述因感染 2019 年冠状病毒病而入住 PICU 的一系列儿童。设计前瞻性观察研究。设置在西班牙马德里的三级医院。患者 2020 年 3 月 1 日至 2020 年 4 月 15 日入住 PICU 的儿童患有严重急性呼吸综合征冠状病毒 2（严重急性呼吸综合征冠状病毒 2）感染。 干预 观察性研究。测量和主要结果 流行病学数据、既往临床特征、需要的支持治疗、影像学检查、入院时的实验室观察和药物治疗。11 名儿童因疑似 2019 年冠状病毒病被送入 PICU；聚合酶链反应试验7例呈阳性。中位年龄为 100.7 个月（范围 0.5-162）。五人从急诊科入院，两人从病房入院。儿科序贯器官衰竭评估评分为 3（范围，0-9），儿科死亡风险 II 评分为 4（范围，0-16）。除一名（异基因造血干细胞移植）外，所有儿童以前都是健康的。呼吸道症状和发烧很普遍。胸片导致肺炎诊断。并非所有患者在入院时都出现淋巴细胞减少症。D-二聚体和铁蛋白升高。所有患者都需要通过鼻导管进行氧疗；5 名患者接受了高流量鼻导管治疗，后来有 4 名患者被无创通气替代。在 PICU 入院的第一天，两名患者需要机械通气。两个孩子需要机械通气和正性肌力支持。托珠单抗应用于两名插管儿童。此外，四个孩子接受了肝素。没有病人死亡。结论 总体而言，这些孩子以前都很健康，并且已经超过 1 岁。呼吸系统症状是入院 PICU 的主要原因，使呼吸支持成为主要治疗方法。需要机械通气的患者在入院第一天表现出恶化。这些孩子似乎需要密切监测，多中心研究是必要的。呼吸系统症状是入院 PICU 的主要原因，使呼吸支持成为主要治疗方法。需要机械通气的患者在入院第一天表现出恶化。这些孩子似乎需要密切监测，多中心研究是必要的。呼吸系统症状是入院 PICU 的主要原因，使呼吸支持成为主要治疗方法。需要机械通气的患者在入院第一天表现出恶化。这些孩子似乎需要密切监测，多中心研究是必要的。