COVID-19-associated hospitalizations among children less than 12 years of age in the United States

Fusco, Manuela Di; Vaghela, Shailja; Moran, Mary; Lin, Jay; Atwell, Jessica E.; Malhotra, Deepa; Sforzolini, Thomas Scassellati; Cané, Alejandro; Nguyen, Jennifer; McGrath, Leah J.

doi:10.1080/13696998.2022.2046401

Cited by 10 publications

(8 citation statements)

References 15 publications

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“…9 In the period for which HES APC data were available, the overall LoS in hospitalized children (3.4 days) was similar to the estimate within a US-based study using claims data (4.3 days). 5 When stratified by age, the US study observed a longer LoS among those 0-4 years (4.1 days) and 5-11 years of age (4.7 days) compared with our study (LoS estimates including general and critical care: 1-4 years: 1.8 days; 5-11 years: 2.8 days). That said, trends showing increasing LoS with increasing age were comparable between studies.…”

Section: Discussioncontrasting

confidence: 64%

“…There is limited data on pediatric health care resource utilization (HCRU) following COVID-19 diagnosis 4,5,15,16 ; these studies were: (1) predominantly based on United States (US) data and, therefore, have limited generalisability to the UK, (2) lacked full coverage of childhood ages or (3) did not report COVID-19-related primary care resource use, for example, general practitioner (GP) consultations. Similarly to the experience of hospitalizations, use of COVID-19 primary care services is likely to vary depending on age and presence of underlying health conditions; however, age and comorbidity-specific variations in GP or nurse visits have not been studied in pediatrics with COVID-19.…”

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confidence: 99%

“…1 Hospitalization for COVID-19 and death are more rare in pediatrics compared to adults. 2,3 Yet, when pediatrics are hospitalized with COVID-19, 8%–22% 4–7 require critical care according to United Kingdom (UK) and international estimates and 4%–9% require respiratory support. 6,8 According to the UK Coronavirus Dashboard, there were 0.46 million cases in those 0–4 years of age, 1.15 million in 5–9 years of age, 1.63 million in 10–14 years of age and 1.40 million in 15–19 years of age, up to April 2023.…”

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confidence: 99%

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Health Care Resource Utilization and Costs Associated With COVID-19 Among Pediatrics Managed in the Community or Hospital Setting in England: A Population-based Cohort Study

Yang,

Andersen,

Rai

et al. 2023

Pediatric Infectious Disease Journal

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Background: Although COVID-19 morbidity is significantly lower in pediatrics than in adults, the risk of severe COVID-19 may still pose substantial health care resource burden. This study aimed to describe health care resource utilization (HCRU) and costs associated with COVID-19 in pediatrics 1–17 years old in England. Methods: A population-based retrospective cohort study of pediatrics with COVID-19 using Clinical Practice Research Datalink (CPRD Aurum) primary care data and, where available, linked Hospital Episode Statistics Admitted Patient Care secondary care data. HCRU and associated costs to the National Health Service were stratified by age, risk of severe COVID-19 and immunocompromised status, separately for those with and without hospitalization records (hospitalized cohort: COVID-19 diagnosis August 2020–March 2021; primary care cohort: COVID-19 diagnosis August 2020–January 2022). Results: This study included 564,644 patients in the primary care cohort and 60 in the hospitalized cohort. Primary care consultations were more common in those 1–4 years of age (face-to-face: 4.3%; telephone: 6.0%) compared with those 5–11 (2.0%; 2.1%) and 12–17 years of age (2.2%; 2.5%). In the hospitalized cohort, mean (SD) length of stay was longer [5.0 (5.8) days] among those 12–17 years old (n = 24) than those 1–4 [n = 15; 1.8 (0.9) days] and 5–11 years old [n = 21; 2.8 (2.1) days]. Conclusions: Most pediatrics diagnosed with COVID-19 were managed in the community. However, hospitalizations were an important driver of HCRU and costs, particularly for those 12–17 years old. Our results may help optimize the management and resource allocation of COVID-19 in this population.

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Section: Discussioncontrasting

confidence: 64%

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confidence: 99%

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confidence: 99%

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Health Care Resource Utilization and Costs Associated With COVID-19 Among Pediatrics Managed in the Community or Hospital Setting in England: A Population-based Cohort Study

Yang,

Andersen,

Rai

et al. 2023

Pediatric Infectious Disease Journal

Self Cite

View full text Add to dashboard Cite

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“…To classify hospitalizations as “for” COVID-19 rather than “with” COVID-19, the COVID-19 diagnosis was required to be present on admission or the principal admitting diagnosis. ICU status was identified using revenue codes, Healthcare Common Procedure Coding System (HCPCS) codes, or Current Procedural Terminology, Fourth Edition ( CPT-4 ) codes as used in a previously defined algorithm [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Coronavirus Disease 2019 Severity and Risk of Subsequent Cardiovascular Events

Wiemken

McGrath

Andersen

et al. 2022

Clinical Infectious Diseases

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Background Little is known about the relationship between COVID-19 severity and subsequent risk of experiencing a cardiovascular event (CVE) after COVID-19 recovery. We evaluated this relationship in a large cohort of US adults. Methods Using a claims database, we performed a retrospective cohort study of adults diagnosed with COVID-19 between April 1, 2020 and May 31, 2021. We evaluated the association between COVID-19 severity and risk of CVE >30 days after COVID-19 diagnosis using inverse probability of treatment weighted competing risks regression. Severity was based on level of care required for COVID-19 treatment: intensive care unit (ICU) admission, non-ICU hospitalization, or outpatient care only. Results 1,357,518 COVID-19 patients were included (2% ICU, 3% non-ICU hospitalization, and 95% outpatient only). Compared to outpatients, there was an increased risk of any CVE for patients requiring ICU admission (adjusted hazard ratio [HR]: 1.80 [95%CI: 1.71−1.89]) or non-ICU hospitalization (HR: 1.28 [1.24−1.33]). Risk of subsequent hospitalization for CVE was even higher (HR: 3.47 [3.20–3.76] for ICU and HR: 1.96 [1.85–2.09] for non-ICU hospitalized vs. outpatient only). Conclusions COVID-19 patients hospitalized or requiring critical care had a significantly higher risk of experiencing and being hospitalized for post-COVID-19 CVE than patients with milder COVID-19 who were managed solely in the outpatient setting even after adjusting for differences between these groups. These findings underscore the continued importance of preventing SARS-CoV-2 infection from progressing to severe illness to reduce potential long-term cardiovascular complications.

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“…The majority of clinical trials, such as the vaccine trials, use different ages but do not list life stages in the selection criteria of research subjects. For example, the trial on the COVID vaccine is divided into a range of ages, such as the age group of 5–11 years ( Di Fusco et al, 2022 ; Kim et al, 2022 ). In the clinical trials of cancer patients, age groups have been widely used as the general rule to describe the response to the treatment, either for children or adults ( Kang et al, 2018 ; Porter et al, 2022 ).…”

Section: Recommendations-the Needs and Benefits In The Application Of...mentioning

confidence: 99%

Bring the life stages into the domain of basic and clinical pharmacology

et al. 2022

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Completely distinct physiological conditions and immune responses exist among different human life stages. Age is not always consistent with the life stage. We proposed to incorporate the concept of the life stages into basic and clinical pharmacology, including clinical trials, drug labels, and drug usage in clinical practice. Life-stage-based medical treatment is the application of medicine according to life stages such as prepuberty, reproductive, and aging. A large number of diseases are life-stage-dependent. Many medications and therapy have shown various age effects but not been recognized as life-stage-dependent. The same dosage and drug applications used in different life stages lead to divergent outcomes. Incorporating life stages in medicine and drug usage will enhance the efficacy and precision of the medication in disease treatment.

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COVID-19-associated hospitalizations among children less than 12 years of age in the United States

Cited by 10 publications

References 15 publications

Health Care Resource Utilization and Costs Associated With COVID-19 Among Pediatrics Managed in the Community or Hospital Setting in England: A Population-based Cohort Study

Health Care Resource Utilization and Costs Associated With COVID-19 Among Pediatrics Managed in the Community or Hospital Setting in England: A Population-based Cohort Study

Coronavirus Disease 2019 Severity and Risk of Subsequent Cardiovascular Events

Bring the life stages into the domain of basic and clinical pharmacology

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