Browsing by Autor "Mariel Andrea Forest-Yepez"

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Relationship between sociodemographic, clinical, and laboratory characteristics and severity of COVID-19 in pediatric patients
(Public Library of Science, 2024) Cristian Roca; Adriana Asturizaga; Nelson Villca; Ramiro Cabrera; Raúl Copana-Olmos; Vladimir Aguilera-Avendaño; Claudia Estrada-Villarroel; Mariel Andrea Forest-Yepez; Marcia Torrez-Santos; Adela Felipa Magne-Calle
COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1–10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2–6.5), breathing difficulty OR: 3.4 (CI95%: 1.4–8.2), vomiting OR: 3.3 (CI95%: 1.4–7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9–16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.
Sepsis Bundle Adherence and Early Vasopressor Administration in Pediatric Septic Shock: Secondary Analysis of Outcomes in a 2023 Multicenter Cohort in Bolivia
(Lippincott Williams & Wilkins, 2025) Raúl Copana-Olmos; Nils Cassón; Willmer Diaz-Villalobos; Victor Urquieta-Clavel; Mary Tejerina-Ortiz; M. Céspedes-Lesczinsky; Vladimir Aguilera-Avendaño; Maricruz Fernández-Vidal; Mariel Andrea Forest-Yepez; Danny Blanco-Espejo
Early initiation of vasoactive agents in children with septic shock and timely sepsis bundle completion were independently associated with lower hazard of mortality. Historically, in Bolivia in 2023, bundle adherence was suboptimal, yet feasible interventions were associated with greater odds of better outcomes in pediatric sepsis and septic shock.
Sepsis in Critically Ill Children in Bolivia: Multicenter Retrospective Evaluation of the Phoenix Criteria for Sepsis in a 2023 Cohort
(Lippincott Williams & Wilkins, 2025) Raúl Copana-Olmos; Nils Casson-Rodriguez; Willmer Diaz-Villalobos; Victor Urquieta-Clavel; Mary Tejerina-Ortiz; Carol Mendoza-Montoya; Maricruz Fernández-Vidal; Mariel Andrea Forest-Yepez; Danny Blanco-Espejo; Ibeth Rivera-Murguia
In this 2023, retrospective cohort of PICU patients with sepsis in Bolivia, we have found that the majority met the 2024 Phoenix sepsis criteria, but less than two-thirds met the SIRS-based criteria for diagnosis. However, the respiratory score in the Phoenix criteria overestimated the severity of respiratory dysfunction in more than half of the cohort, likely because the score does not take account of the Andean adaptation to high altitude, with higher oxygen carrying capacity.