Comorbidities Associated with Hospitalization and Progression Among Adolescents with Symptomatic Coronavirus Disease 2019

Dubois, Melanie; Campbell, Jeffrey I.; Savage, Timothy J.; Hood-Pishchany, M. Indriati; Sharma, Tanvi; Petty, Carter R.; Lamb, Gabriella S; Nakamura, Mari

doi:10.1016/j.jpeds.2022.02.048

Cited by 26 publications

(20 citation statements)

References 37 publications

(47 reference statements)

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“…As observed in adult cohorts, the coexistence of comorbidities, including diabetes, obesity, kidney disease, and hematology/oncology, has been clearly associated with severe illness and mortality in pediatric patients with COVID-19. 3,[23][24][25][26] However, our results also showed a history of asthma without another associated underlying medical condition as a strong protective factor against fatal outcomes in children and adolescents hospitalized with SARS-CoV-2 infection during the first 2 years of the pandemic in Brazil. Notably, compared with healthy children, this group had an approximately 60% reduction in risk of death (HR = 0.39, 95% CI, 0.29-0.56).…”

Section: Asthma Cohortsupporting

confidence: 48%

“…We found that the presence of comorbidities and the presence of asthma associated with chronic medical conditions tripled and doubled the risk of death compared to healthy children. As observed in adult cohorts, the coexistence of comorbidities, including diabetes, obesity, kidney disease, and hematology/oncology, has been clearly associated with severe illness and mortality in pediatric patients with COVID‐19 3,23–26 …”

Section: Discussionmentioning

confidence: 90%

“…Elderly individuals and patients with chronic illnesses are at increased risk of poor outcomes 1 . In adults and children, epidemiological studies have elucidated several risk factors for severe illness and death, including diabetes, obesity, and hypertension 2,3 …”

Section: Introductionmentioning

confidence: 99%

“…1 In adults and children, epidemiological studies have elucidated several risk factors for severe illness and death, including diabetes, obesity, and hypertension. 2,3 As part of the initial response to the COVID-19 pandemic, based more on common sense than on collected evidence, several public health guidelines have included moderate-severe asthma as a risk factor for poor COVID-19 outcomes. 4 In fact, earlier studies in the pandemic crises have suggested that adults with history of asthma are at greater risk of critical COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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The association between pre‐existing asthma and reduced risk of death among children and adolescents hospitalized with COVID‐19 in Brazil

Oliveira

Colosimo²,

Vasconcelos

et al. 2022

Pediatric Pulmonology

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Objective There have been conflicting reports on the relationship between asthma and COVID‐19 severity. This study aimed to compare the risk of death among children with asthma and healthy peers hospitalized due to COVID‐19. Methods We carried out an analysis of all pediatric patients 2–19 years of age with asthma and COVID‐19 registered in Influenza Epidemiological Surveillance Information System‐Gripe, a Brazilian nationwide surveillance database, between February 2020 and March 2022. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk using the cumulative incidence function. Results Among 30,405 hospitalized children with COVID‐19, 21,340 (70.2%) had no comorbidities, 6444 (21.2%) had comorbidities other than asthma, 2165 (7.1%) had asthma, and 465 (1.5%) had asthma with other comorbidities. The estimated probability of a fatal outcome for each group was 4.1%, 14.9%, 2.1%, and 10.7%, respectively. After adjustment, children with asthma had a 60% reduction in the hazard of death than healthy peers (hazard ratio [HR] = 0.39, 95% confidence interval [CI], 0.29–0.53, p < 0.0001). Among children with asthma and no other comorbidities, two covariates were independently associated with in‐hospital mortality, age ≥12 years, HR = 4.0, 95% CI, 2.5–6.4), and low oxygen saturation at admission (HR = 2.3, 95% CI, 1.4–3.2). Conclusion Children with asthma and no comorbidities had a lower risk of death compared with healthy peers after controlling for clinical and demographic confounding factors.

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Section: Asthma Cohortsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The association between pre‐existing asthma and reduced risk of death among children and adolescents hospitalized with COVID‐19 in Brazil

Oliveira

Colosimo²,

Vasconcelos

et al. 2022

Pediatric Pulmonology

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“…In contrast, the strongest risk factors for severe COVID-19 illness, defined as an intensive care unit (ICU) or step-down unit admission, invasive mechanical ventilation, or death, were type 1 diabetes and cardiac and circulatory congenital anomalies. Campbell et al 31 reported data from the Pediatric COVID-19 US Registry in which a race/ethnicity-adjusted model demonstrated sickle cell disease, immunocompromising condition, obesity, diabetes, neurologic, and pulmonary disease were independently associated with increased odds of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Omicron Variant (B.1.1.529) Infection in Children and Adolescents Hospitalized With COVID-19 in Brazil With Observational Data on the Efficacy of the Vaccines in Adolescents

Oliveira¹,

Oliveira²,

Silva³

et al. 2022

Pediatric Infectious Disease Journal

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Oliveira et al responsibility for the integrity of the data and the accuracy of the data analysis. FIGURE 3. Predictors of death among 7442 participants who tested positive for SARS-CoV-2 during the omicronpredominant period. Data are from the competing-risk survival analysis (A) Model for the entire cohort, adjusted hazard ratios. (B) Model for individuals 12-19 years of age, adjusted hazard ratios. Error bars indicate 95% CI. Unvaccinated children were assigned as the reference category.

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The association of sickle cell disorder with adverse outcomes in COVID‐19 patients: A meta‐analysis

Liang,

Guo,

et al. 2023

Journal of Medical Virology

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The aim is to elucidate the relationship between sickle cell disorder and severe COVID‐19. We systematically searched the required articles in three electronic databases, extracting and pooling effect sizes (ES) and 95% confidence interval (CI) from each eligible study to evaluate the effect of combined sickle cell disorder on adverse consequences in patients with COVID‐19. This meta‐analysis included 21 studies. Sickle cell disease (SCD) was a risk factor for mortality (pooled ES = 1.70, 95% CI: 1.00–2.92, p = 0.001), hospitalization (pooled ES = 6.21, 95% CI: 3.60–10.70, p = 0.000) and intensive care unit (ICU) admission (pooled ES = 2.29, 95% CI: 1.61–3.24, p = 0.099) in COVID‐19 patients. Patients with SCD had an increased risk of respiratory failure/mechanical ventilation, but a statistical association was not found (pooled ES = 1.21, 95%CI: 0.74‐1.98, p = 0.036). There was significant heterogeneity between SCD and death, hospitalization, and respiratory failure/mechanical ventilation. The results of meta‐regression of SCD and hospitalization suggested that the tested variables including Area (p = 0.642), study design (p = 0.739), sample size (p = 0.397), proportion of males (p = 0.708), effect type (p = 0.723), whether confounding factors are adjusted (p = 0.606) might not be the source of heterogeneity. In addition, sickle cell trait (SCT) was significantly associated with the mortality (pooled ES = 1.54, 95% CI: 1.28–1.85, p = 0.771) and hospitalization (pooled ES = 1.20, 95% CI: 1.07–1.35，p = 0.519) in patients with COVID‐19. But any increased risk of ICU admission/severe (pooled ES = 1.24, 95% CI: 0.95–1.62, p = 0.520) and mechanical ventilation (OR = 1.00, 95%CI:0.59‐1.69) in COVID‐19 patients with SCT was not observed. Sensitivity analysis demonstrated that the results were robust. The results of the funnel plot and Egger's test did not support the existence of publication bias. Current meta‐analysis indicated that sickle cell disorder has a meaningful impact on COVID‐19 progression to severe cases and associated deaths. However, further investigations and research to validate the current findings is indispensable.

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Comorbidities Associated with Hospitalization and Progression Among Adolescents with Symptomatic Coronavirus Disease 2019

Cited by 26 publications

References 37 publications

The association between pre‐existing asthma and reduced risk of death among children and adolescents hospitalized with COVID‐19 in Brazil

The association between pre‐existing asthma and reduced risk of death among children and adolescents hospitalized with COVID‐19 in Brazil

Clinical Outcomes of Omicron Variant (B.1.1.529) Infection in Children and Adolescents Hospitalized With COVID-19 in Brazil With Observational Data on the Efficacy of the Vaccines in Adolescents

The association of sickle cell disorder with adverse outcomes in COVID‐19 patients: A meta‐analysis

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