Rapid whole genome sequencing has clinical utility in children in the PICU
Open accessAbstract
Objectives: Genetic disorders are a leading contributor to mortality in the neonatal ICU and PICU in the United States. Although individually rare, there are over 6,200 single-gene diseases, which may preclude a genetic diagnosis prior to ICU admission. Rapid whole genome sequencing is an emerging method of diagnosing genetic conditions in time to affect ICU management of neonates; however, its clinical utility has yet to be adequately demonstrated in critically ill children. This study evaluates next-generation sequencing in pediatric critical care. Design: Retrospective cohort study. Setting: Single-center PICU in a tertiary children’s hospital. Patients: Children 4 months to 18 years admitted to the PICU who were nominated between July 2016 and May 2018. Interventions: Rapid whole genome sequencing with targeted phenotype-driven analysis was performed on patients and their parents, when parental samples were available. Measurements and Main Results: A molecular diagnosis was made by rapid whole genome sequencing in 17 of 38 children (45%). In four of the 17 patients (24%), the genetic diagnoses led to a change in management while in the PICU, including genome-informed changes in pharmacotherapy and transition to palliative care. Nine of the 17 diagnosed children (53%) had no dysmorphic features or developmental delay. Eighty-two percent of diagnoses affected the clinical management of the patient and/or family after PICU discharge, including avoidance of biopsy, administration of factor replacement, and surveillance for disorder-related sequelae. Conclusions: This study demonstrates a retrospective evaluation for undiagnosed genetic disease in the PICU and clinical utility of rapid whole genome sequencing in a portion of critically ill children. Further studies are needed to identify PICU patients who will benefit from rapid whole genome sequencing early in PICU admission when the underlying etiology is unclear.
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Rapid WGS has clinical utility in decreasing infant morbidity.
“reflecting the clinical utility of rapid WGS in decreasing infant morbidity.”
From Interstitial lung disease and pancreatic exocrine insufficiency in <scp>CADDS</scp>: Phenotypic expansion and literature review (2023) · cites this paper as [15]
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Self-citationParents’ experiences of decision making for rapid genomic sequencing in intensive care
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Self-citationExome and Whole Genome Sequencing in the Neonatal Intensive Care Unit
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The diagnostic trajectory of infants and children with clinical features of genetic disease
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Evaluating use of changing technologies for rapid next-generation sequencing in pediatrics
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Self-citationWhole‐genome sequencing holds the key to the success of gene‐targeted therapies
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Self-citationClinical Application of Whole Exome Sequencing for Monogenic Disorders in PICU of China
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Rapid Whole Genome Sequencing in Critically Ill Neonates Enables Precision Medicine Pipeline
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Healthcare Professionals’ Attitudes toward Rapid Whole Genome Sequencing in Pediatric Acute Care
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Self-citationChild Neurology: Late-Onset Vitamin B 6 –Dependent Epilepsy Identified by Rapid Genome Sequencing
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Rapid Whole Genome Sequencing and Fulfilling the Promise of Precision Pediatric Critical Care*
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Ethical Considerations of Genome Sequencing for Pediatric Patients
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Clinical genome sequencing: Three years’ experience at a tertiary children’s hospital
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Exome sequencing as the first‐tier test for pediatric respiratory diseases: A single‐center study
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Impact of prenatal genomics on clinical genetics practice
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Avidity sequencing of whole genomes from retinal degeneration pedigrees identifies causal variants
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A holistic approach to maximise diagnostic output in trio exome sequencing
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Self-citationRapid Genome Sequencing Diagnosis in Pediatric Patients with Liver Dysfunction
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Implementation of First-Line Rapid Genome Sequencing in Non–Critical Care Pediatric Wards
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Self-citationTime to diagnosis in rapid exome/genome sequencing in the clinical inpatient setting
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Clinical Genomics in Critically Ill Infants and Children
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Self-citationRisk Variants in the Exomes of Children With Critical Illness
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Long-term follow-up of children who received rapid genomic sequencing
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Self-citationPalliative Care Outcomes for Critically ill Children After Rapid Whole Genome Sequencing
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Self-citationClin.iobio: A Collaborative Diagnostic Workflow to Enable Team-Based Precision Genomics
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A retrospective cohort analysis of the Yale pediatric genomics discovery program
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- Authors
- Sanford, E. F., Clark, M. M., Farnaes, L., Williams, M. R., Perry, J. C., Ingulli, E. G., Sweeney, N. M., Doshi, A., Gold, J. J., Briggs, B., Bainbridge, M. N., Feddock, M., Watkins, K., Chowdhury, S., Nahas, S. A., Dimmock, D. P., Kingsmore, S. F., & Coufal, N. G.
- Affiliations
- Department of Pediatrics, University of California at San Diego, La Jolla, CA.
- Rady Children's Institute for Genomic Medicine (US)
- University of California San Diego (US)
- Rady Children's Hospital-San Diego (US)
- ORCID
- Venue
- Pediatric Critical Care Medicine
- Published
- 2019-11
- Volume
- 20
- Issue
- 11
- Pages
- 1007-1020
- ISSN
- 1529-7535 (ISSN-L)
- PMC
- PMC6832787
- OpenAlex
- W2956112893
- Cited by
- 150
- References
- 44
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 24 · 2023: 22 · 2022: 34 · 2021: 19 · 2020: 17 · 2019: 2 · 2012: 1
- FWCI
- 10.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pediatric Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U19HD077693)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Keywords
- rapid whole genome sequencing, pediatric intensive care unit, critically ill children, genetic diagnosis, monogenic disorders, molecular diagnosis, pharmacogenomics, palliative care, factor substitution, clinical utility
- MeSH terms
- Whole Genome Sequencing, Adolescent, Child, Child, Preschool, Female, Humans, Infant, Male, Retrospective Studies, Intensive Care Units, Pediatric, Critical Illness, Genetic Diseases, Inborn, Precision Medicine
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