Clinical Profile, Outcome and Risk Factors for Mortality Among Children Admitted with Critical Pertussis: An Ambispective Study.

OBJECTIVE

To study the clinical and microbiological profile, outcome, and risk factors for mortality in children with critical pertussis.

METHODS

An ambispective study included children admitted to the pediatric intensive care unit diagnosed with critical pertussis (n = 75) between November 2022 and June 2023. Diagnosis was confirmed by real-time polymerase chain reaction (PCR) and outcomes were recorded.

RESULTS

Out of 75 cases, 57 (76%) tested positive for Bordetella infection (34 B. pertussis, 23 other species). Nearly half were children < 3.5 months of age. Common clinical features were fever, paroxysmal cough and tachypnea. Chest radiograph in all cases revealed diffuse infiltrates. Complications included hypoxemia (n = 69, 92%), shock (n = 41, 54.7%), encephalopathy (n = 38, 50.7%) and seizures (n = 29, 38.7%). Sixty-three (84%) patients needed mechanical ventilation and 38 (50.7%) expired. Presence of shock was identified as an independent risk factor for mortality (aOR (95%CI) 7.63 (2.11, 27.59); P = 0.002).

CONCLUSION

Critical pertussis commonly presents with severe pneumonia and can be caused by B. pertussis and other Bordetella species. Presence of shock is associated with a high risk of mortality in children with critical pertussis.