tetano
Editor, Senior Moderator
Pediatrics
. 2022 Mar 24;e2021055765.
doi: 10.1542/peds.2021-055765. Online ahead of print.
Severity of Acute COVID-19 in Children <18 Years Old March 2020 to December 2021
Christopher B Forrest[SUP] 1 [/SUP], Evanette K Burrows[SUP] 1 [/SUP], Asuncion Mejias[SUP] 2 [/SUP], Hanieh Razzaghi[SUP] 1 [/SUP], Dimitri Christakis[SUP] 3 [/SUP], Ravi Jhaveri[SUP] 4 [/SUP], Grace M Lee[SUP] 5 [/SUP], Nathan M Pajor[SUP] 6 [/SUP], Suchitra Rao[SUP] 7 [/SUP], Deepika Thacker[SUP] 8 [/SUP], L Charles Bailey[SUP] 1 [/SUP]
Affiliations
Abstract
Background and objectives: High transmissibility of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant led to increased coronavirus disease 2019 (COVID-19) cases, but its effect on severe illness among children is less clear. This study evaluated changes in COVID-19 severity from March 1, 2020, to December 30, 2021.
Methods: We examined electronic health record data from encounters that occurred in outpatient and inpatient settings in 9 health systems participating in PEDSnet. The study sample included children aged <18 years with a positive viral test for SARS-CoV-2. Severity was categorized as asymptomatic, mild (symptoms), moderate (moderately severe COVID-19-related conditions such as gastroenteritis, dehydration, and pneumonia), or severe (unstable COVID-19-related conditions, ICU admission, or mechanical ventilation).
Results: The number of patients classified as asymptomatic was 54 948 (66.4%), with 22 303 (26.9%) being mild, 3781 (4.6%) being moderate, and 1766 (2.1%) being severe. In 2021, patients with moderate to severe illness peaked in June (13.5%), declining to December (8.1%). Compared with July 2020 to February 2021, the adjusted odds ratio for moderate to severe illness was highest in June 2021 (adjusted odds ratio, 2.8; 95% confidence interval, 2.2-3.6) and lower in July to December 2021, when the Delta variant predominated. The adjusted odds ratio for moderate to severe illness among children with complex chronic conditions was 4.2 (95% confidence interval, 3.9-4.5).
Conclusions: Although 1 in 16 children infected with the SARS-CoV-2 virus experienced moderate or severe illness, the risk of severe disease did not change with the emergence of the Delta variant, despite its high transmissibility.
. 2022 Mar 24;e2021055765.
doi: 10.1542/peds.2021-055765. Online ahead of print.
Severity of Acute COVID-19 in Children <18 Years Old March 2020 to December 2021
Christopher B Forrest[SUP] 1 [/SUP], Evanette K Burrows[SUP] 1 [/SUP], Asuncion Mejias[SUP] 2 [/SUP], Hanieh Razzaghi[SUP] 1 [/SUP], Dimitri Christakis[SUP] 3 [/SUP], Ravi Jhaveri[SUP] 4 [/SUP], Grace M Lee[SUP] 5 [/SUP], Nathan M Pajor[SUP] 6 [/SUP], Suchitra Rao[SUP] 7 [/SUP], Deepika Thacker[SUP] 8 [/SUP], L Charles Bailey[SUP] 1 [/SUP]
Affiliations
- PMID: 35322270
- DOI: 10.1542/peds.2021-055765
Abstract
Background and objectives: High transmissibility of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant led to increased coronavirus disease 2019 (COVID-19) cases, but its effect on severe illness among children is less clear. This study evaluated changes in COVID-19 severity from March 1, 2020, to December 30, 2021.
Methods: We examined electronic health record data from encounters that occurred in outpatient and inpatient settings in 9 health systems participating in PEDSnet. The study sample included children aged <18 years with a positive viral test for SARS-CoV-2. Severity was categorized as asymptomatic, mild (symptoms), moderate (moderately severe COVID-19-related conditions such as gastroenteritis, dehydration, and pneumonia), or severe (unstable COVID-19-related conditions, ICU admission, or mechanical ventilation).
Results: The number of patients classified as asymptomatic was 54 948 (66.4%), with 22 303 (26.9%) being mild, 3781 (4.6%) being moderate, and 1766 (2.1%) being severe. In 2021, patients with moderate to severe illness peaked in June (13.5%), declining to December (8.1%). Compared with July 2020 to February 2021, the adjusted odds ratio for moderate to severe illness was highest in June 2021 (adjusted odds ratio, 2.8; 95% confidence interval, 2.2-3.6) and lower in July to December 2021, when the Delta variant predominated. The adjusted odds ratio for moderate to severe illness among children with complex chronic conditions was 4.2 (95% confidence interval, 3.9-4.5).
Conclusions: Although 1 in 16 children infected with the SARS-CoV-2 virus experienced moderate or severe illness, the risk of severe disease did not change with the emergence of the Delta variant, despite its high transmissibility.