Incidence, etiology, sociodemographic and clinical characterization of acute respiratory failure in pediatric patients at a high-altitude city: A multicenter cohort study

Sarha M Vargas Muñoz; Sara De Vivero Haddad; Aldo M Beltran; Carolina Bonilla Gonzalez; Melisa Naranjo Vanegas; Sergio Moreno-Lopez; Paola Rueda-Guevara; Pedro Barrera; Juan Gabriel Piñeros; Luz Marina Mejía; María Lucia Mesa; Sonia Restrepo-Gualteros; Olga Lucía Baquero Castañeda; Andrea Ramírez Varela

doi:10.3389/fped.2022.1009375

Incidence, etiology, sociodemographic and clinical characterization of acute respiratory failure in pediatric patients at a high-altitude city: A multicenter cohort study

Front Pediatr. 2022 Dec 15:10:1009375. doi: 10.3389/fped.2022.1009375. eCollection 2022.

Authors

Affiliations

¹ Department of Pediatrics, Universidad de los Andes, Medical School, Bogotá, Colombia.
² Pediatric Intensive Care Unit, Fundación Santa Fe de Bogotá University, Bogotá, Colombia.
³ Department of Public Health, Faculty of Science, Universidad de los Andes, Bogotá, Colombia.
⁴ Pediatric Intensive Care Unit, Medical Epidemiologist, Fundación Santa Fe de Bogotá University, Bogotá, United States, Colombia.
⁵ Department of Pediatrics FARA Group, Bogotá, Colombia.
⁶ PDH Epidemiology, Bogotá, Colombia.

Abstract

Background: Acute respiratory failure is a life-threatening medical condition, associated with a variety of conditions and risk factors, including acute respiratory diseases which are a frequent cause of pediatric morbidity and mortality worldwide. In Colombia, the literature related to ARF is scarce.

Objective: To determine the incidence, causes, and sociodemographic and clinical characteristics of ARF in three hospitals in Bogota, a high-altitude city located in Colombia, during the COVID-19 pandemic.

Methods: A multicenter prospective cohort study called the FARA cohort was developed between April 2020 - December 2021. Patients older than one month and younger than 18 years with respiratory distress who developed ARF were included.

Results: 685 patients with respiratory distress were recruited in 21 months. The incidence density of ARF was found to be 41.7 cases per 100 person-year CI 95%, (37.3-47.7). The median age was 4.5 years.. Most of the patients consulted during the first 72 h after the onset of symptoms. Upon admission, 67.2% were potentially unstable. The most frequent pathologies were asthma, bronchiolitis, pneumonia, and sepsis. At admission, 75.6% of the patients required different oxygen delivery systems, 29,5% a low-flow oxygen system, 36,8% a high-flow oxygen system, and 9,28% invasive mechanical ventilation. SARS-COV-2, respiratory syncytial virus, rhinovirus/enterovirus, and adenovirus were the most frequently isolated viral agents. The coinfection cases were scarce.

Conclusions: This multicenter study, the FARA cohort, developed at 2,600 meters above sea level, shows the first data on incidence, etiology, sociodemographic and clinical characterization in a pediatric population with ARF that also concurs with the COVID-19 pandemic. These results, not only have implications for public health but also contribute to the scientific and epidemiological literature on a disease developed at a high altitude.

Keywords: acute respiratory failure (ARF); high altitude; multicenter study design; pediatric cohort study; pediatric critical care.