Objective We aimed to evaluate the characteristics and outcomes of critically ill children managed in an intensive care unit because of coronavirus disease (COVID-19) pneumonia with respiratory support requirements. Methods We performed a single-center retrospective observational study in a pediatric intensive care unit (PICU) with 32 beds in Ankara City Hospital, Ankara, Turkey, from 13 March 2020 to 31 December 2020. Patients who needed positive-pressure ventilation (PPV) therapy for COVID-19 pneumonia were included in the study. Demographic, clinical and laboratory data were extracted from the patients’ electronic medical records. As outcomes, the hospitalization rate of all pediatric patients diagnosed as having with COVID-19 by Polymerase Chaın Reactıon(PCR), PICU admission rate for COVID-19 pneumonia among all hospitalized patients, PPV support rate, intensive care hospitalization duration (days), total hospitalization duration (days), survival rate and tracheotomy requirement were evaluated. Results During the study period, 7033 children tested positive for COVID-19 in PCR tests. Of these patients, 1219 were hospitalized for COVID-19. Seventeen patients needed PPV support because of COVID-19 pneumonia. High proportion (65%) of patients admitted to the PICU had comorbid diseases. Noninvasive ventilation was applied in 15 patients (88%). The hospitalization rate among the children with COVID-19 was 17%, of whom 1.6% were admitted to the PICU. Mortality rates were 0.056% of all the cases and 0.32% of the hospitalized patients in our hospital. Conclusion The presence of a comorbid disease could be a sign of severe disease in children with higher lethality. Very few children required PPV support because of severe COVID-19 pneumonia.

中文翻译：

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转诊医院儿科患者的严重冠状病毒病肺炎

目的 我们旨在评估因需要呼吸支持的冠状病毒病 (COVID-19) 肺炎而在重症监护室接受治疗的危重儿童的特征和结局。方法 我们于 2020 年 3 月 13 日至 2020 年 12 月 31 日在土耳其安卡拉市医院的 32 张床位的儿科重症监护病房 (PICU) 进行了一项单中心回顾性观察研究。需要正压通气 (PPV) 的患者研究中包括了 COVID-19 肺炎的治疗。从患者的电子病历中提取人口统计学、临床和实验室数据。作为结果，聚合酶链反应 (PCR) 诊断为 COVID-19 的所有儿科患者的住院率，所有住院患者中 COVID-19 肺炎的 PICU 入院率，评估PPV支持率、重症监护住院时间（天）、总住院时间（天）、存活率和气管切开需求。结果 在研究期间，7033 名儿童在 PCR 测试中检测出 COVID-19 呈阳性。在这些患者中，有 1219 人因 COVID-19 住院。由于 COVID-19 肺炎，17 名患者需要 PPV 支持。入住 PICU 的患者中有高比例 (65%) 患有合并症。15 名患者 (88%) 采用了无创通气。COVID-19 患儿的住院率为 17%，其中 1.6% 入​​住 PICU。我院所有病例的病死率为0.056%，住院患者的病死率为0.32%。结论 合并症的存在可能是高致死率儿童重症的标志。