Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19

Details

• Alternative Title:
  Hosp Pediatr
• Personal Author:
  Choudhary, Rewa ; Webber, Bryant J. ; Womack, Lindsay S. ; Dupont, Hannah K. ; Chiu, Sophia K. ; Wanga, Valentine ; Gerdes, Megan E. ; Hsu, Sophia ; Shi, Dallas S. ; Dulski, Theresa M. ; Idubor, Osatohamwen I. ; Wendel, Arthur M. ; Agathis, Nickolas T. ; Anderson, Kristi ; Boyles, Tricia ; Click, Eleanor S. ; Da Silva, Juliana ; Evans, Mary E. ; Gold, Jeremy A.W. ; Haston, Julia C. ; Loga, Pamela ; Maloney, Susan A. ; Martinez, Marisol ; Natarajan, Pavithra ; Spicer, Kevin B. ; Swancutt, Mark ; Stevens, Valerie A. ; Rogers-Brown, Jessica ; Chandra, Gyan ; Light, Megan ; Barr, Frederick E. ; Snowden, Jessica ; Kociolek, Larry K. ; McHugh, Matthew ; Wessel, David L. ; Simpson, Joelle N. ; Gorman, Kathleen C. ; Breslin, Kristen A. ; DeBiasi, Roberta L. ; Thompson, Aaron ; Kline, Mark W. ; Boom, Julie A. ; Singh, Ila R. ; Dowlin, Michael ; Wietecha, Mark ; Schweitzer, Beth ; Morris, Sapna Bamrah ; Koumans, Emilia H. ; Ko, Jean Y. ; Siegel, David A. ; Kimball, Anne A.
• Description:
  OBJECTIVES:
  
  To describe coronavirus disease 2019 (COVID-19)–related pediatric hospitalizations during a period of B.1.617.2 (Δ) variant predominance and to determine age-specific factors associated with severe illness.
  
  METHODS:
  
  We abstracted data from medical charts to conduct a cross-sectional study of patients aged <21 years hospitalized at 6 United States children’s hospitals from July to August 2021 for COVID-19 or with an incidental positive severe acute respiratory syndrome coronavirus 2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation.
  
  RESULTS:
  
  Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with respiratory syncytial virus (RSV) (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1 to 4 years (PR 1.96); and obesity in patients aged 5 to 11 (PR 2.20) and 12 to 17 years (PR 2.48). Having ≥2 underlying medical conditions was associated with severe illness in patients aged <1 (PR 1.82), 5 to 11 (PR 3.72), and 12 to 17 years (PR 3.19).
  
  CONCLUSIONS:
  
  Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged <5 years, obesity in those aged 5 to 17 years, and other underlying conditions for all age groups <18 years. These findings can inform pediatric practice, risk communication, and prevention strategies, including vaccination against COVID-19.
  
  
• Subjects:
  Article Child Coinfection COVID-19 Cross-Sectional Studies Hospitalization Humans Infant Obesity Respiratory Syncytial Virus Infections SARS-CoV-2 United States

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• Source:
  Hosp Pediatr. 12(9):760-783
• Pubmed ID:
  35670605
• Pubmed Central ID:
  PMC9773098
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  12
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:338f1f47bbc9bc6a2a5fbff3dd2eea558dfdef055a49772a58f40e080a0f3979
• Download URL:
  https://stacks.cdc.gov/view/cdc/123024/cdc_123024_DS1.pdf
• File Type:
  [PDF - 667.12 KB ]