64: Investigating Correlations Between Risk Factors and Outcomes in Patients With COVID-19 in the PICU

INTRODUCTION: With the ongoing COVID-19 pandemic and the evolving epidemiology in children, it is important to identify factors associated with outcomes in the pediatric ICU (PICU) Although emerging research suggests that patient weight and race are associated with outcome, this has not been fully evaluated after adjusting for severity of illness (SOI) This analysis investigates the relation between SOI, clinical risk factors such as weight, race, and clinical course of patients and outcomes (survival/mortality) of patients with COVID-19 in the PICU METHODS: 432 COVID-19 patients under 18 years old distributed among 64 PICUs in various geographic regions across the US were included in the analyses Data from the national Virtual Pediatric Systems registry was used to investigate correlations between factors associated with mortality and Pediatric Risk of Mortality (PRISM III) probability of death (POD) to reflect SOI Pearson and Spearman correlations were calculated for different subgroups of the cohort between SOI and the following: BMI, weight, age, medical and physical length of stay (MLOS/PLOS), and length of invasive ventilation (LOV) BMI was adjusted for pediatric males and females using the CDC growth charts Preliminary logistic regressions were developed using PRISM III for predicting outcomes RESULTS: In the non-African American/non-Hispanic subgroup, significant positive correlations were found between weight and SOI (R=0 168/p=0 033) and between age and SOI (R=0 168/p=0 034) However, BMI was not significantly correlated with SOI in the subgroups studied Significant positive correlation (p <0 001) was found between MLOS and SOI and between PLOS and SOI for the survivor (R=0 404;R=0 401), obese (R=0 497;R=0 489), and combined African American/Hispanic (R=0 438;R=0 433) subgroups The survivor (R=0 242/p=0 018), obese (R=0 535/p=0 049), and Hispanic (R=0 512/ p=0 006) subgroups had significant positive correlations between LOV and SOI The logistic regression predicting outcomes using PRISM III POD was tested to determine the feasibility of developing such a model (N=8 mortalities), and resulted in an AROC=75 1% and Hosmer-Lemeshow goodness of fit test with p=0 81 CONCLUSIONS: Race, obesity are correlated with outcomes;PRISM III appears to predict mortality in PICU COVID-19 patients