Demographic predictors of hospitalization and mortality in US children with COVID-19

Moreira, Álvaro; Chorath, Kevin; Rajasekaran, Karthik; Burmeister, Fiona; Ahmed, Mubbasheer; Moreira, Axel

doi:10.1007/s00431-021-03955-x

Cited by 80 publications

(87 citation statements)

References 9 publications

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“…This differs from previous studies reporting whether children and adolescents that were admitted to a hospital with a chronic comorbidity had an increased risk of ICU transfer or death. 7-10 Because a very low percentage of children and adolescents required admission (0.47%), our findings provide new information on risk factors for infection regardless of severity. None of the chronic comorbidities were associated with an increased risk of infection.…”

Section: Discussionmentioning

confidence: 78%

“…This is important, as other studies have also raised concern for such an association in children, and this finding was in contrast to most previous studies among hospital-based cohorts of children and adolescents. 7-10 However, these studies did not provide data that separated the risk of infection from hospitalisation. The current data suggests that a skewed distribution of country of origin among hospitalised children was driven by differences in the spread of infection in society and not by susceptibility to severe disease, in line with a recent US study on risk factors for severe covid-19.…”

Section: Discussionmentioning

confidence: 99%

“…5 Country of origin has been associated with an increased risk of hospitalisation, but it is unclear whether this is related to socioeconomic factors or increased susceptibility to the virus. 7-10…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for SARS-CoV-2 infection and hospitalisation in children and adolescents in Norway: A nationwide population-based study

Størdal

Ruiz

Greve-Isdahl

et al. 2021

Preprint

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Objective: To determine risk factors for SARS-CoV-2 infection and hospitalisation among children and adolescents. Design: Nationwide, population-based cohort study. Setting: Norway from 1 March 2020 to 31 April 2021. Participants: All Norwegian residents <18 years of age. Main outcome measures: Population-based health care and population registries were used to study risk factors for SARS-CoV-2 infection, including socioeconomic factors, country of origin, and pre-existing chronic comorbidities. All residents were followed until age 18, emigration, death, or end of follow-up. Hazard ratios (HR) estimated by Cox regression models were adjusted for testing frequency. Further, risk factors for admission to the hospital among the infected were investigated. Results: Of 1 182 796 residents, 22608 (1.9%) tested positive by polymerase chain reaction or lateral flow tests, of whom 107 (0.5%) were admitted to a hospital. Low family income (aHR 1.40, 95% confidence interval 1.36 to 1.46), crowded housing (1.35, 1.30 to 1.39), household size, age, and area of living were independent risk factors for infection. A non-Nordic country of origin was the strongest risk factor (aHR 2.37, 95% CI 2.30 to 2.49), whereas chronic comorbidity was not associated with the risk of infection. Chronic comorbidity was associated with hospitalisation (aHR 4.15, 2.63 to 6.56), in addition to age, whereas socioeconomic status and country of origin did not predict hospitalisation among those infected. Conclusions: Socioeconomic factors, country of origin, and area of living were associated with the risk of SARS-CoV-2 infection. However, these factors did not predict hospitalisation among those infected. Chronic comorbidity was associated with the risk of admission but not with the overall risk of acquiring SARS-CoV-2.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Risk factors for SARS-CoV-2 infection and hospitalisation in children and adolescents in Norway: A nationwide population-based study

Størdal

Ruiz

Greve-Isdahl

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…As data have continued to be collected, and the pandemic has progressed, both have been implicated as independent strong risk factors for severe illness with increased risk of mortality. [8][9][10][11] One of the reason for obesity as a maker for disease severity could be increased pro-inflammatory response observed in overweight individuals. In addition, obese individuals are often difficult to ventilate and rehabilitate.…”

Section: Discussionmentioning

confidence: 99%

Death from COVID-19 in a Hispanic postpartum woman and review of the literature

et al. 2021

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There is still much we do not know about the impact of COVID-19 on the health of pregnant and postpartum women and pregnancy outcomes. Current evidence suggests that there is biological plausibility for worse outcomes among this population. This case report details the clinical care given to a postpartum Hispanic and obese woman diagnosed with COVID-19 in April 2020. We report the care she and her newborn received and her progression through the virus. We discuss the current knowledge surrounding COVID-19 among pregnant and postpartum women. While research supports COVID-19 outcomes being comparable to the general population, there is limited research in this area. Clinical trials, acting on the side of caution, have tended to exclude pregnant women from participation. Therefore, there is a need for further research that can inform evidence-based policy decisions related to COVID-19 in pregnant and postpartum women.

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“…The second is a delayed in ammatory condition referred to as Paediatric In ammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS) or Multisystem In ammatory Syndrome in Children (MIS-C) (4)(5)(6). Postulated risk factors for developing more severe COVID-19 or PIMS-TS / MIS-C include existing co-morbid conditions, age, sex, ethnicity, socio-economic group, and geographical location (7)(8)(9)(10). Existing systematic evaluations are not useful for guiding policy as reviews were undertaken early in the pandemic (11)(12)(13), included highly heterogeneous groups and a wide range of outcomes from very small studies (14), and failed to distinguish between acute COVID-19 and PIMS-TS/MIS-C.…”

Section: Introductionmentioning

confidence: 99%

Which children and young people are at higher risk of severe disease and death after SARS-CoV-2 infection: a systematic review and individual patient meta-analysis

Harwood

Yan²,

Camara

et al. 2021

Preprint

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Background We aimed to use individual patient data to describe pre-existing factors associated with severe disease, primarily admission to critical care, and death secondary to SARS-CoV-2 infection in children and young people (CYP) in hospital.Methods We searched Pubmed, European PMC, Medline and Embase for case series and cohort studies that included all CYP admitted to hospital with 30 CYP with SARS-CoV-2 or 5 CYP with PIMS-TS or MIS-C. Eligible studies contained 1) details of age, sex, ethnicity or co-morbidities, and 2) an outcome which included admission to critical care, mechanical invasive ventilation, cardiovascular support, or death. Studies reporting outcomes in more restricted grouping of co-morbidities were eligible for narrative review. Authors of eligible studies were approached for individual patient data (IPD). We used random effects meta-analyses for aggregate study-level data and multilevel mixed effect models for IPD data to examine risk factors (age, sex, comorbidities) associated with admission to critical care and death. Data shown are odds ratios and 95% confidence intervals (CI).Findings 81 studies were included, 57 in the meta-analysis (of which 22 provided IPD) and 26 in the narrative synthesis. Most studies had an element of bias in their design or reporting. Sex was not associated with critical care or death. Compared with CYP aged 1-4 years, infants had increased odds of admission to critical care (OR 1.63 (95% CI 1.40-1.90)) and death (OR 2.08 (1.57-2.86)). Odds of death were increased amongst CYP over 10 years (10-14 years OR 2.15 (1.54-2.98); >14 years OR 2.15 (1.61-2.88)). Number of comorbid conditions was associated with increased odds of admission to critical care and death for COVID-19 in a dose-related fashion. For critical care admission odds ratios were: 1 comorbidity 1.49 (1.45-1.53); 2 comorbidities 2.58 (2.41-2.75); ≥3 comorbidities 2.97 (2.04-4.32), and for death: 1 comorbidity 2.15 (1.98-2.34); 2 comorbidities 4.63 (4.54-4.74); ≥3 co-morbidities 4.98 (3.78-6.65). Odds of admission to critical care were increased for all co-morbidities apart from asthma (0.92 (0.91-0.94)) and malignancy (0.85 (0.17-4.21)) with an increased odds of death in all co-morbidities considered apart from asthma. Neurological and cardiac comorbidities were associated with the greatest increase in odds of severe disease or death. Obesity increased the odds of severe disease and death independently of other comorbidities.Interpretation Hospitalised CYP at greatest vulnerability of severe disease or death from SARS-CoV-2 infection are infants, teenagers, those with cardiac or neurological conditions, or 2 or more comorbid conditions, and those who are obese. These groups should be considered higher priority for vaccination and for protective shielding when appropriate. Whilst odds ratios were high, the absolute increase in risk for most comorbidities was small compared to children without underlying conditions.

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Demographic predictors of hospitalization and mortality in US children with COVID-19

Cited by 80 publications

References 9 publications

Risk factors for SARS-CoV-2 infection and hospitalisation in children and adolescents in Norway: A nationwide population-based study

Risk factors for SARS-CoV-2 infection and hospitalisation in children and adolescents in Norway: A nationwide population-based study

Death from COVID-19 in a Hispanic postpartum woman and review of the literature

Which children and young people are at higher risk of severe disease and death after SARS-CoV-2 infection: a systematic review and individual patient meta-analysis

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