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Open Forum Infect Dis . Clinical Features and Outcomes of Pediatric and Adult Patients Hospitalized for Coronavirus Disease 2019: A Comparison Acro

tetano

Editor, Senior Moderator
Open Forum Infect Dis


. 2024 Aug 10;11(8):ofae443.
doi: 10.1093/ofid/ofae443. eCollection 2024 Aug. Clinical Features and Outcomes of Pediatric and Adult Patients Hospitalized for Coronavirus Disease 2019: A Comparison Across Age Strata

Grace X Li[SUP] 1 [/SUP], Komal Gopchandani[SUP] 1 [/SUP], Noah Brazer[SUP] 2 3 [/SUP], Ashley Tippett[SUP] 1 [/SUP], Chris Choi[SUP] 1 [/SUP], Hui-Mien Hsiao[SUP] 1 [/SUP], Miriam Oseguera[SUP] 2 3 [/SUP], Abiodun Foresythe[SUP] 2 3 [/SUP], Sanchita Bhattacharya[SUP] 4 [/SUP], Venice Servellita[SUP] 2 3 [/SUP], Alicia Sotomayor Gonzalez[SUP] 2 3 [/SUP], Jennifer K Spinler[SUP] 5 6 [/SUP], Mark D Gonzalez[SUP] 7 [/SUP], Dalia Gulick[SUP] 8 [/SUP], Colleen Kraft[SUP] 9 10 [/SUP], Vyjayanti Kasinathan[SUP] 10 [/SUP], Yun F Wayne Wang[SUP] 10 11 [/SUP], Jennifer Dien Bard[SUP] 12 13 [/SUP], Pei Ying Chen[SUP] 12 13 [/SUP], Jessica Flores-Vazquez[SUP] 12 13 [/SUP], Audrey R Odom John[SUP] 14 15 [/SUP], Paul J Planet[SUP] 14 15 [/SUP], Sridevi Devaraj[SUP] 5 6 [/SUP], Ananth V Annapragada[SUP] 16 17 [/SUP], Ruth Ann Luna[SUP] 5 6 [/SUP], Charles Y Chiu[SUP] 2 3 [/SUP], Christina A Rostad[SUP] 1 18 [/SUP]



Affiliations
Abstract

Background: Coronavirus disease 2019 (COVID-19) continues to cause hospitalizations and severe disease in children and adults.
Methods: This study compared the risk factors, symptoms, and outcomes of children and adults hospitalized for COVID-19 from March 2020 to May 2023 across age strata at 5 US sites participating in the Predicting Viral-Associated Inflammatory Disease Severity in Children with Laboratory Diagnostics and Artificial Intelligence consortium. Eligible patients had an upper respiratory swab that tested positive for severe acute respiratory syndrome coronavirus 2 by nucleic acid amplification. Adjusted odds ratios (aOR) of clinical outcomes were determined for children versus adults, for pediatric age strata compared to adolescents (12-17 years), and for adult age strata compared to young adults (22-49 years).
Results: Of 9101 patients in the Predicting Viral-Associated Inflammatory Disease Severity in Children with Laboratory Diagnostics and Artificial Intelligence cohort, 1560 were hospitalized for COVID-19 as the primary reason. Compared to adults (22-105 years, n = 675), children (0-21 years, n = 885) were less commonly vaccinated (14.3% vs 34.5%), more commonly infected with the Omicron variant (49.5% vs 26.1%) and had fewer comorbidities (P < .001 for most comparisons), except for lung disease (P = .24). After adjusting for confounding variables, children had significantly lower odds of receiving supplemental oxygen (aOR, 0.57; 95% confidence interval, .35-.92) and death (aOR, 0.011; 95% confidence interval, <.01-.58) compa--red to adults. Among pediatric age strata, adolescents 12-17 years had the highest odds of receiving supplemental oxygen, high-flow oxygen, and ICU admission. Among adults, those 50-64 years had the highest odds of mechanical ventilation and ICU admission.
Conclusions: Clinical outcomes of COVID-19 differed across pediatric and adult age strata. Adolescents experienced the most severe disease among children, whereas adults 50-64 years experienced the most severe disease among adults.

Keywords: SARS-CoV-2; adults; children; coronavirus; coronavirus disease 2019.

 
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