Mohammad Alghounaim, Naila A. Shaheen, Aldaithan, Abdulrahman, Saif Awlad Thani, Yasser Kazzar, Abdulla Alfraij, on behalf of the Gulf Pediatric Pertussis Study (GPPS) Group
Amiri Hospital. King Abdullah International Medical Research Center. King Saud bin Abdulaziz University for Health Sciences. Farwaniya Hospital. Ahmadi Hospital. Royal Hospital. Ministry of National Guard Health Affairs.
Kuwait, Saudi Arabia and Oman
Pediatric Critical Care Medicine
Pediatr Crit Care Med 2026;
DOI: 10.1097/PCC.0000000000003956
Abstract
Objectives: Critical pertussis is a life-threatening illness that predominantly affects young infants, with substantial morbidity and mortality. In this study, we aimed to describe the epidemiology, clinical features, and variability in management of pediatric critical pertussis in the Gulf Cooperation Council (GCC) region.
Design: Multinational retrospective cohort study conducted between July 2022 and December 2024.
Setting: Thirty-five PICUs in the six GCC countries.
Patients: Children 16 years old or younger with laboratory-confirmed pertussis (by polymerase chain reaction or culture) admitted to a PICU.
Interventions: None.
Measurements and main results: A total of 204 cases of critical pertussis were identified. Median (interquartile range [IQR]) age was 53 days (IQR, 36.5-89 d). Most patients (91.2%) were healthy before PICU admission. Comorbidities included acyanotic congenital heart disease (3.9%) or respiratory disease (2.9%). Only 17.3% had received infant pertussis vaccination and 4.1% had mothers vaccinated during pregnancy. The median duration of hospital stay was 9 days (IQR, 6-16 d), and PICU stay was 5 days (IQR, 3-10 d). Hyperleukocytosis (> 30 × 109/L) occurred in 49.5%. Respiratory distress (47.6%) and apnea (28.4%) were the main reasons for PICU admission. Management varied widely: leukoreduction was performed in 27.4%, with significant variation in practice across countries. Use of high-flow nasal cannula and mechanical also varied across the region. Extracorporeal membrane oxygenation was rarely used (1.5%). Echocardiography was obtained in nearly half of the cohort, and revealed pulmonary hypertension in 24 patients. Overall mortality was 15.2%, most commonly attributed to septic shock and respiratory failure.
Conclusions: Critical pertussis predominantly affects young infants, with substantial morbidity, mortality, and wide variation in management practices. Our cohort from 2022 to 2024 highlights our GCC regional need for standardized care protocols and strengthened prevention.
Category
Class I. Pulmonary Hypertension Associated with Infection
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes