tetano
Editor, Senior Moderator
Pediatrics
. 2021 Dec 22;e2021053418.
doi: 10.1542/peds.2021-053418. Online ahead of print.
Risk Factors for Severe COVID-19 in Children
Rebecca C Woodruff[SUP] 1 2 [/SUP], Angela P Campbell[SUP] 1 [/SUP], Christopher A Taylor[SUP] 1 [/SUP], Shua J Chai[SUP] 2 3 4 [/SUP], Breanna Kawasaki[SUP] 5 [/SUP], James Meek[SUP] 6 [/SUP], Evan J Anderson[SUP] 7 8 9 [/SUP], Andy Weigel[SUP] 10 [/SUP], Maya L Monroe[SUP] 11 [/SUP], Libby Reeg[SUP] 12 [/SUP], Erica Bye[SUP] 13 [/SUP], Daniel M Sosin[SUP] 14 15 [/SUP], Alison Muse[SUP] 16 [/SUP], Nancy M Bennett[SUP] 17 [/SUP], Laurie M Billing[SUP] 18 [/SUP], Melissa Sutton[SUP] 19 [/SUP], H Keipp Talbot[SUP] 20 [/SUP], Keegan McCaffrey[SUP] 21 [/SUP], Huong Pham[SUP] 1 [/SUP], Kadam Patel[SUP] 1 22 [/SUP], Michael Whitaker[SUP] 1 [/SUP], Meredith L McMorrow[SUP] 1 2 [/SUP], Fiona P Havers[SUP] 1 2 [/SUP]
Affiliations
Abstract
Objectives: Describe population-based rates and risk factors for severe coronavirus disease 2019 (COVID-19) (ie, ICU admission, invasive mechanical ventilation, or death) among hospitalized children.
Methods: During March 2020 to May 2021, the COVID-19-Associated Hospitalization Surveillance Network identified 3106 children hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in 14 states. Among 2293 children primarily admitted for COVID-19, multivariable generalized estimating equations generated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) of the associations between demographic and medical characteristics abstracted from medical records and severe COVID-19. We calculated age-adjusted cumulative population-based rates of severe COVID-19 among all children.
Results: Approximately 30% of hospitalized children had severe COVID-19; 0.5% died during hospitalization. Among hospitalized children aged <2 years, chronic lung disease (aRR: 2.2; 95% CI: 1.1-4.3), neurologic disorders (aRR: 2.0; 95% CI: 1.5‒2.6), cardiovascular disease (aRR: 1.7; 95% CI: 1.2‒2.3), prematurity (aRR: 1.6; 95% CI: 1.1‒2.2), and airway abnormality (aRR: 1.6; 95% CI: 1.1‒2.2) were associated with severe COVID-19. Among hospitalized children aged 2 to 17 years, feeding tube dependence (aRR: 2.0; 95% CI: 1.5‒2.5), diabetes mellitus (aRR: 1.9; 95% CI: 1.6‒2.3) and obesity (aRR: 1.2; 95% CI: 1.0‒1.4) were associated with severe COVID-19. Severe COVID-19 occurred among 12.0 per 100 000 children overall and was highest among infants, Hispanic children, and non-Hispanic Black children.
Conclusions: Results identify children at potentially higher risk of severe COVID-19 who may benefit from prevention efforts, including vaccination. Rates establish a baseline for monitoring changes in pediatric illness severity after increased availability of COVID-19 vaccines and the emergence of new variants.
. 2021 Dec 22;e2021053418.
doi: 10.1542/peds.2021-053418. Online ahead of print.
Risk Factors for Severe COVID-19 in Children
Rebecca C Woodruff[SUP] 1 2 [/SUP], Angela P Campbell[SUP] 1 [/SUP], Christopher A Taylor[SUP] 1 [/SUP], Shua J Chai[SUP] 2 3 4 [/SUP], Breanna Kawasaki[SUP] 5 [/SUP], James Meek[SUP] 6 [/SUP], Evan J Anderson[SUP] 7 8 9 [/SUP], Andy Weigel[SUP] 10 [/SUP], Maya L Monroe[SUP] 11 [/SUP], Libby Reeg[SUP] 12 [/SUP], Erica Bye[SUP] 13 [/SUP], Daniel M Sosin[SUP] 14 15 [/SUP], Alison Muse[SUP] 16 [/SUP], Nancy M Bennett[SUP] 17 [/SUP], Laurie M Billing[SUP] 18 [/SUP], Melissa Sutton[SUP] 19 [/SUP], H Keipp Talbot[SUP] 20 [/SUP], Keegan McCaffrey[SUP] 21 [/SUP], Huong Pham[SUP] 1 [/SUP], Kadam Patel[SUP] 1 22 [/SUP], Michael Whitaker[SUP] 1 [/SUP], Meredith L McMorrow[SUP] 1 2 [/SUP], Fiona P Havers[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34935038
- DOI: 10.1542/peds.2021-053418
Abstract
Objectives: Describe population-based rates and risk factors for severe coronavirus disease 2019 (COVID-19) (ie, ICU admission, invasive mechanical ventilation, or death) among hospitalized children.
Methods: During March 2020 to May 2021, the COVID-19-Associated Hospitalization Surveillance Network identified 3106 children hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in 14 states. Among 2293 children primarily admitted for COVID-19, multivariable generalized estimating equations generated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) of the associations between demographic and medical characteristics abstracted from medical records and severe COVID-19. We calculated age-adjusted cumulative population-based rates of severe COVID-19 among all children.
Results: Approximately 30% of hospitalized children had severe COVID-19; 0.5% died during hospitalization. Among hospitalized children aged <2 years, chronic lung disease (aRR: 2.2; 95% CI: 1.1-4.3), neurologic disorders (aRR: 2.0; 95% CI: 1.5‒2.6), cardiovascular disease (aRR: 1.7; 95% CI: 1.2‒2.3), prematurity (aRR: 1.6; 95% CI: 1.1‒2.2), and airway abnormality (aRR: 1.6; 95% CI: 1.1‒2.2) were associated with severe COVID-19. Among hospitalized children aged 2 to 17 years, feeding tube dependence (aRR: 2.0; 95% CI: 1.5‒2.5), diabetes mellitus (aRR: 1.9; 95% CI: 1.6‒2.3) and obesity (aRR: 1.2; 95% CI: 1.0‒1.4) were associated with severe COVID-19. Severe COVID-19 occurred among 12.0 per 100 000 children overall and was highest among infants, Hispanic children, and non-Hispanic Black children.
Conclusions: Results identify children at potentially higher risk of severe COVID-19 who may benefit from prevention efforts, including vaccination. Rates establish a baseline for monitoring changes in pediatric illness severity after increased availability of COVID-19 vaccines and the emergence of new variants.