Clinical outcomes of COVID-19 and influenza in hospitalized children <5 years in the US

Abstract

IntroductionWe compared hospitalization outcomes of young children hospitalized with COVID-19 to those hospitalized with influenza in the United States.MethodsPatients aged 0-&amp;lt;5 years hospitalized with an admission diagnosis of acute COVID-19 (April 2021-March 2022) or influenza (April 2019-March 2020) were selected from the PINC AI Healthcare Database Special Release. Hospitalization outcomes included length of stay (LOS), intensive care unit (ICU) admission, oxygen supplementation, and mechanical ventilation (MV). Inverse probability of treatment weighting was used to adjust for confounders in logistic regression analyses.ResultsAmong children hospitalized with COVID-19 (n = 4,839; median age: 0 years), 21.3% had an ICU admission, 19.6% received oxygen supplementation, 7.9% received MV support, and 0.5% died. Among children hospitalized with influenza (n = 4,349; median age: 1 year), 17.4% were admitted to the ICU, 26.7% received oxygen supplementation, 7.6% received MV support, and 0.3% died. Compared to children hospitalized with influenza, those with COVID-19 were more likely to have an ICU admission (adjusted odds ratio [aOR]: 1.34; 95% confidence interval [CI]: 1.21–1.48). However, children with COVID-19 were less likely to receive oxygen supplementation (aOR: 0.71; 95% CI: 0.64–0.78), have a prolonged LOS (aOR: 0.81; 95% CI: 0.75–0.88), or a prolonged ICU stay (aOR: 0.56; 95% CI: 0.46–0.68). The likelihood of receiving MV was similar (aOR: 0.94; 95% CI: 0.81, 1.1).ConclusionsHospitalized children with either SARS-CoV-2 or influenza had severe complications including ICU admission and oxygen supplementation. Nearly 10% received MV support. Both SARS-CoV-2 and influenza have the potential to cause severe illness in young children.

Inpatient Burden of COVID-19 in Japan: A Retrospective Cohort Study

“…(12–16) Trends were similar, although with a narrower magnitude of difference, in pediatrics: longer length of stay, yet fewer children admitted to ICU or receiving IMV in Japan as compared to the US. (13,17–21) Systematic reviews have previously reported regional differences similar to those outlined above. (22)…”

Increased disease severity during COVID-19 related hospitalization in black non-hispanic, hispanic and medicaid-insured young children

“…This study used a retrospective cohort design to characterize hospitalization outcomes among children aged <5 years and hospitalized with COVID-19 ( 15 ). The data source was the nationally representative PINC AI™ (formerly Premier) Healthcare Database Special Edition (PHD SR), which covers approximately a quarter of all hospital admissions annually arising from ∼1,400 hospitals in the U.S.…”

“…Disease severity was based on the outcomes of interest which included length of stay (LOS), intensive care unit (ICU) admission, oxygen supplementation, invasive mechanical ventilatory (IMV) support, and prolonged duration of each outcome. Prolonged duration was defined as longer than the median value among all patients who experienced that outcome (>2 days for each outcome) ( 15 ).…”