Page 96 - Abstract Book KONIKA 18

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O-RES-001
Incidence and Risk Factor for Pneumonia
in Children with Spastic Cerebral Palsy

Aldilla Faiza, Darmawan Budi S, Irawan Mangunatmadja, Pramita Gayatri
Department of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo
General Hospital, Jakarta, Indonesia

Abstract
Background Pneumonia is one of the causes of mortality in children with cerebral palsy (CP) because
of its severe clinical manifestations and a greater risk of respiratory failure than normal children. The
incidence of pneumonia in CP children varies up to 20%. Children with CP have various dysfunctions that
are closely related to respiratory problems, but there are still few studies that prove their relationship to the
incidence of pneumonia. Objective To determine the incidence of pneumonia in children with spastic CP, the
influence of the severity of CP (assessed by GMFCS), tetra paresis, epilepsy, obstructive sleep apnea (OSA),
impaired airway clearance, GERD, and dysphagia on the incidence of pneumonia. Methods Observational,
cross-sectional study, 82 patients with cerebral palsy (age 2-18 patient) were included in this study.
Results The incidence of pneumonia was 37.8%. According to multivariate analysis, the risk factors most
related to pneumonia were impaired airway clearance (P=0.011, adjusted OR 10.995, 95%CI 3.087 to
39.160) and dysphagia (P<0.001, adjusted OR 8.641, 95%CI 1.650 to 45.244). Impaired airway clearance
and dysphagia have a major role in the development of pneumonia. Conclusion Impaired airway clearance
and dysphagia have an important role in the incidence of pneumonia in PS children. Bulbar dysfunction has
greater risk factor for pneumonia compared to motoric dysfunction as found in children with tetra paresis CP.
Keywords: cerebral palsy; pneumonia; spastic

O-RES-002
Anemia at Admission may Represents as A Poor Prognostic Factor
in COVID-19 Cases in Children: A Single Center Retrospective Cohort Study
Fahreza Aditya Neldy, Nastiti Kaswandani, Madeleine Ramdhani Jasin, Wahyuni Indawati,
Darmawan Budi Setyanto, Bambang Supriyatno, Wanda Gautami, Mulki Angela Prajnya Paramita,
Prihatina Anjela
Department of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta,
Indonesia

Abstract
Background Acute respiratory distress syndrome (ARDS) in COVID-19 will lead to tissue-hypoxia.
Hemoglobin plays significant role in oxygen transport. Low level of hemoglobin (anemia) is expected to
aggravate tissue hypoxia in ARDS. To date, no reports specifically addressed the investigation of anemia in
COVID-19 in children. Objective To assess whether anemia at admission have prognostic value in children
with COVID-19. Methods A retrospective cohort performed in Cipto Mangunkusumo Hospital, Jakarta,
from September 2020 to July 2021 by collecting data from children with COVID-19. We used ROC-curve
to predict fatal outcome and calculated odd-ratio (OR). Subgrup analysis were also performed. Results
Total of 228 subjects participated in this study, 9.2% of them are anemic. In ROC analysis, anemia have an
acceptable value (AUC 0.73; 95%CI 0.6 to 0.85) to predict mortality. Having anemia at admission has more
risk to develop fatal outcome (unadjusted OR 4.54; [1.48-13.9]). Risk to fatal outcome in anemia presumed
to happen in dose-dependent manner as the risk to fatal outcome in hemoglobin below 8 g/dL are higher
compare to hemoglobin level below 10 g/dL (11.2 [4.2-29.6] vs. 3.3 [1.3-8.3]). In subgroup analysis, both in
hematologic cases or non-hematologic cases group and severe COVID-19 group, anemia may possess notable
risk with OR 4.2, 3.6, 1.4, (P>0.05). Conclusion Anemia at admission may represents poor prognostic factor
in COVID-19 in children. Larger data are needed to carefully assess whether anemia is truly independent
risk factor to cause fatal outcome.
Keywords: COVID-19; children; mortalit; anemia; Indonesia

50 KONIKA XVIII Abstract Book