• Aleksandra Korzeniewska-Eksterowicz, Olga Brzezinska, Urszula Dryja, Dominka Matczak, Andriy Sopilnyak, Eugenia Szuszkiewicz, Łukasz Przysło, Krzystof Szmyd, Katarzyna Jabłońska, Piotr Krych, Agnieszka Wojtków-Zielińska, Edyta Wąsińska, and Maciej Niedźwiecki.
• Pediatric Palliative Care Unit, Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland.
• Palliat Med. 2024 Jan 1; 38 (1): 150155150-155.

BackgroundStudies have shown the risk factors for COVID-19 severity in children, including comorbidities, but information on the infection course in children with life-limiting conditions is sparse.AimTo describe the effect of COVID-19 on pediatric patients receiving palliative care due to life-limiting conditions.DesignWe conducted retrospective cohort study. The WHO Clinical Progression Scale was used to measure COVID-19 severity.Setting/ParticipantsSeven of the 24 invited pediatric palliative care centers participated in this study. We analyzed the medical records of children under palliative care with confirmed COVID-19 (January 2020-April 2022).ResultsRecords of 60 patients with COVID-19 aged 0.24 to 21.6 years (mean (SD); 9.8 (6.6)) were collected. The largest group of patients with COVID-19 was children with congenital malformations and chromosomal abnormalities (42%); the most common manifestation was fever (85%). Bacterial coinfection was confirmed in 17 (28%) children. Fifteen (25%) children required hospitalization, including four admitted to the Intensive Care Unit. Mild COVID-19 was identified in 44 (73%) children, moderate in 11 (18%), severe in 3 (5%), and death in 2 (3%). Six of the 20 eligible children were vaccinated against SARS-CoV-2, followed by 16 mothers and fathers.ConclusionIn the study population initial presentation of COVID-19 was predominantly a mild; however, the small sample size precluded definitive conclusions. For children under palliative care, we should identify if they have an advance care plan for COVID-19, such as desires for intensive care support. Further studies are needed to define the short and long-term effects of COVID-19 in children with life-limiting conditions.

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