Risk Factors for Severe Pediatric Invasive Group A Streptococcal Disease

What are the risk factors associated with severe invasive group A streptococcus (iGAS) disease, defined a intensive care admission and/or death?In this cohort study of 617 children with pediatric iGAS, severe disease was associated with a post–COVID-19 pandemic diagnosis, pulmonary involvement, streptococcal toxic shock syndrome, and meningitis or encephalitis. Significant clinical risk factors were reduced consciousness, dyspnea, abnormal auscultation, elevated C-reactive protein, and decreased estimated glomerular filtration rate.The identification of specific risk factors for severe iGAS may raise awareness among clinicians to recognize at-risk cases and to improve clinical outcomes.

Corresponding Author: Evelien B. van Kempen, MD, MSc, Department of Paediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands (e.vankempen@hagaziekenhuis.nl).

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