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COVID-19-associated deaths have been reported in the United States.* Reports of U.S. patients hospitalized with SARS-CoV-2 infection (the virus that causes COVID-19) describe high proportions of older, male, and black persons (2-4). Similarly, when comparing hospitalized patients with catchment area populations or nonhospitalized COVID-19 patients, high proportions have underlying conditions, including diabetes mellitus, hypertension, obesity, cardiovascular disease, chronic kidney disease, or chronic respiratory disease (3,4). For this report, data were abstracted from the medical records of 220 hospitalized and 311 nonhospitalized patients aged ≥18 years with laboratory-confirmed COVID-19 from six acute care hospitals and associated outpatient clinics in metropolitan Atlanta, Georgia. Multivariable analyses were performed to identify patient characteristics associated with hospitalization. The following characteristics were independently associated with hospitalization: age ≥65 years (adjusted odds ratio [aOR] = 3.4), black race (aOR = 3.2), having diabetes mellitus (aOR = 3.1), lack of insurance (aOR = 2.8), male sex (aOR = 2.4), smoking (aOR = 2.3), and obesity (aOR = 1.9). Infection with SARS-CoV-2 can lead to severe outcomes, including death, and measures to protect persons from infection, such as staying at home, social distancing (5), and awareness and management of underlying conditions should be emphasized for those at highest risk for hospitalization with COVID-19. Measures that prevent the spread of infection to others, such as wearing cloth face coverings (6), should be used whenever possible to protect groups at high risk. Potential barriers to the ability to adhere to these measures need to be addressed. Patients were selected from six acute care hospitals and associated outpatient clinics affiliated with a single academic health care system in metropolitan Atlanta. Hospitalized patients were selected sequentially from hospital-provided lists of * https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html.

Key Points Question Among children with a COVID-19 diagnosis, what conditions are common, and which are associated with severe COVID-19 illness? Findings In this cross-sectional study of 43 465 patients aged 18 years or younger with COVID-19, more than one-quarter had 1 or more underlying condition; asthma, obesity, neurodevelopmental disorders, and certain mental health conditions were most common. Certain conditions as well as medical complexity were associated with a higher risk of severe COVID-19 illness. Meaning These findings expand the knowledge available regarding children with COVID-19 and could inform pediatric clinical practice and public health priorities, such as prevention and mitigation of COVID-19.

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