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

Details

• Personal Author:
  Agathis NT ; Anderson, Kern E. ; Barr FE ; Boom JA ; Boyles T ; Breslin KA ; Chandra G ; Chiu SK ; Choudhary R ; Click ES ; Da Silva J ; DeBiasi RL ; Dowlin M ; Dulski TM ; Dupont HK ; Evans ME ; Gerdes ME ; Gold JAW ; Gorman KC ; Haston JC ; Hsu S ; Idubor OI ; Kimball AA ; Kline MW ; Ko JY ; Kociolek LK ; Koumans EH ; Light M ; Logan, Perry W. ; Maloney SA ; Martinez M ; McHugh M ; Morris SB ; Natarajan P ; Rogers-Brown J ; Schweitzer B ; Shi, Dallas S. ; Siegel DA ; Simpson JN ; Singh IR ; Snowden J ; Spicer KB ; Stevens VA ; Swancutt M ; Thompson A ; Wanga V ; Webber BJ ; Wendel AM ; Wessel DL ; Wietecha M ; Womack LS
• Description:
  OBJECTIVES: To describe coronavirus disease 2019 (COVID-19)-related pediatric hospitalizations during a period of B.1.617.2 (delta) 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. [Description provided by NIOSH]
• Subjects:
  Age Factors Communicable Diseases Occupational Health Safety Viral Diseases
• Keywords:
  Age Factors Children Coronavirus COVID-19 Cross Sectional Studies Disease Incidence Infectious Diseases Medical Records Obesity SARS-CoV-2 Viral Infections

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• ISSN:
  2154-1663
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Arkansas ; District of Columbia ; Georgia ; Illinois ; Louisiana ; Maryland ; Ohio ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 6 ; Texas ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering ; WTCHP - World Trade Center Health Program ; OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  12
• Issue:
  9
• NIOSHTIC Number:
  nn:20066409
• Citation:
  Hosp Pediatr 2022 Sep; 12(9):760-783
• Contact Point Address:
  Rewa Choudhary, MD, MPH, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd Northeast, Atlanta, Georgia 30329
• Email:
  nwa5@cdc.gov
• Federal Fiscal Year:
  2022
• Peer Reviewed:
  True
• Source Full Name:
  Hospital Pediatrics
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f8730dfd5b3e20f671e6fd7fb52894aaf131ddcd0cdd40aa6ed5a0b2418b83789aab943c6e49a2f4357b88336d9701d57e6b6ad05cbfc65148bf673474916706
• Download URL:
  https://stacks.cdc.gov/view/cdc/212855/cdc_212855_DS1.pdf
• File Type:
  [PDF - 886.35 KB ]