In 2020, more than 2  million pediatric COVID-19 cases were reported in the United States. Although approximately half of pediatric patients with COVID-19 experience mild disease, some children require admission to intensive care units or use of invasive mechanical ventilation. Preston, et al. (2021) conducted a cohort study to estimate adjusted associations between demographic and clinical characteristics and severe COVID-19 among hospitalized pediatric patients.

Discharge data from 869 medical facilities that contributed inpatient and emergency department encounters to the Premier Healthcare Database Special COVID-19 Release (PHD-SR) (release date, December 9, 2020), an administrative all-payer database capturing approximately 20% of US hospitalizations, were used to describe patients 18 years or younger who had an inpatient or emergency department encounter with a primary or secondary COVID-19 discharge diagnosis from March 1 through October 31, 2020.

Severe COVID-19 was defined as care requiring treatment in an intensive care unit or step-down unit, involving use of invasive mechanical ventilation, or resulting in death. The researchers used the Agency for Healthcare Research and Quality Chronic Condition Indicator tool to identify chronic conditions using ICD-10-CM diagnoses from January 1, 2019, up to and including the child’s initial COVID-19 encounter. Race/ethnicity was defined by information in patient medical records in the PHD-SR.

Among 20,714 pediatric patients with COVID-19, 10,950 (52.9%) were girls, 11,153 (53.8%) were aged 12 to 18 years, 8148 (39.3%) were Hispanic or Latino individuals, 5054 (24.4%) were non-Hispanic Black individuals. Among these patients with COVID-19, 6047 (29.2%) had 1 or more chronic conditions.

Among the cohort of 2430 pediatric patients (11.7%) who were hospitalized with COVID-19, 756 (31.1%) experienced severe COVID-19. An increased association of severe COVID-19 was observed among patients with 1 or more chronic conditions vs those with none (AOR, 3.27; 95% CI, 2.44-4.37); in children aged 2 through 5 years or 6 through 11 years vs those aged 12 through 18 years (AORs, 1.53; 95% CI, 1.11-2.13 and 1.53; 95% CI, 1.04-2.23, respectively); and in male vs female patients (AOR, 1.52; 95% CI, 1.26-1.83). There was no statistically significant association between race/ethnicity or insurance type and severe COVID-19.

Reference: Preston LE, et al. Characteristics and Disease Severity of US Children and Adolescents Diagnosed With COVID-19. JAMA Netw Open. 2021;4(4):e215298. doi:10.1001/jamanetworkopen.2021.5298