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Risk Factors for Severe COVID-19 in Children
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1 2022
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Source: Pediatrics. 149(1)
Details:
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Alternative Title:Pediatrics
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Description:Objectives:
Describe population-based rates and risk factors for severe COVID-19 (i.e., intensive care unit admission, invasive mechanical ventilation, or death) among hospitalized children.
Methods:
During March 2020–May 2021, the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) identified 3,106 children with laboratory-confirmed SARS-CoV-2 infection who were hospitalized in 14 states. Among a subset of 2,293 children primarily admitted for COVID-19, we used multivariable generalized estimating equations to generate adjusted risk ratios (aRRs) and 95% confidence intervals (CI) of the association between demographic and medical characteristics abstracted from patient electronic 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 and 0.5% died during hospitalization. Among hospitalized children aged <2 years, chronic lung disease (aRR=2.2, CI: 1.1–4.3), neurologic disorders (aRR=2.0, CI: 1.5‒2.6), cardiovascular disease (aRR=1.7, CI: 1.2‒2.3), prematurity (aRR=1.6, CI: 1.1‒2.2) and airway abnormality (aRR=1.6,CI: 1.1‒2.2) were associated with severe COVID-19. Among hospitalized children aged 2‒17 years, feeding tube dependence (aRR=2.0, CI: 1.5‒2.5), diabetes mellitus (aRR=1.9, CI: 1.6‒2.3) and obesity (aRR=1.2, CI: 1.0‒1.4) were associated with severe COVID-19. Severe COVID-19 occurred among 12.0 per 100,000 children aged <18 years, and was highest among infants, Hispanic children, and non-Hispanic Black children.
Conclusions:
Results identify children at potentially higher risk of severe disease who may benefit from COVID-19 prevention efforts, including vaccination. Rates of severe COVID-19 establish a baseline for monitoring changes in pediatric illness severity following increased availability of COVID-19 vaccines and the emergence of new variants.
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Pubmed ID:34935038
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Pubmed Central ID:PMC9213563
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