Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments

Funk, Anna; Florin, Todd A.; Kuppermann, Nathan; Tancredi, Daniel J.; Xie, Jianling; Kim, Kelly; Neuman, Mark I.; Ambroggio, Lilliam; Plint, Amy C.; Mintegi, Santiago; Klassen, Terry P.; Salvadori, M; Malley, Richard; Payne, Daniel C.; Simon, Norma-Jean; Yock‐Corrales, Adriana; Nebhrajani, Jasmine R.; Chaudhari, Pradip P.; Breslin, Kristen; Finkelstein, Yaron; Campos, Carmen; Bergmann, Kelly R.; Bhatt, Maala; Ahmad, Fahd A.; Gardiner, Michael; Avva, Usha; Shah, Nipam; Sartori, L.; Sabhaney, Vikram; Caperell, Kerry; Navanandan, Nidhya; Borland, Meredith L; Morris, Claudia R.; Gangoiti, Iker; Pavlicich, Viviana; Kannikeswaran, Nirupama; Lunoe, Maren M.; Rino, Pedro; Kam, April J.; Cherry, Jonathan C.; Rogers, Alexander; Chong, Shu-Ling; Palumbo, Laura; Angelats, Carlos M.; Morrison, Andrea K.; Kwok, Maria Y.; Becker, Sarah M.; Dixon, Andrew; Poonai, Naveen; Eckerle, Michelle; Wassem, Muhammad; Dalziel, Stuart R; Freedman, Stephen B.; Gómez‐Vargas, Jessica; Lerman, Bethany; Chamberlain, James M.; Owolabi, Adebola; Gentil, Camilla Schanche-Perret; Ringold, Sofie; Perez, Jocy; Velden, Heidi Vander; Crawford, Tyrus; Schultz, Steven; Ross, Kimberly; Monroe, Kathy; Stillwell, Karly; Benedetti, Jillian; O’Brien, Sharon; Pimenta, Kyle; Andrade, Amia; Isacoff, Adam; Sikes, Kendra; Gold, Nina; Reichard, Kathleen; Nemetski, Maureen; Avva, Pavani; Mistry, Rakesh D.; Young, Shanon; Cook, Marlena; Barrena, V. Gómez; Ramírez, Sandra Castejón; Castellanos, María T García; Patterson, Emma; Samuel, A Tisherman; Carciurmaru, Redjana; Fitzpatrick, Eleanor; Bonisch, Megan; Wright, Bruce; Sivakumar, Mithra; Candelaria, Patricia; Cervantes, Vincent; Manoranjithan, Shaminy; Khan, Nabeel; Harbour, Toni; Sethuraman, Usha; Spencer, Priya; Gupta, Neha; Kamboj, Amira; Muanamputu, Gael; Loncarica, Guillermo Kohn; Hernández, Eugenia; Dragovetzky, Ana; Ferré, Isabel Beneyto; Torres, Sylvia; Zorc, Joseph J.; Haber, Rebecca A.; Hiong, Ren Mee; Dewi, Dianna Sri; Joubert, Gary; Dasilva, Kamary Coriolano; Ochs, Julie; Arrighini, A.; Dallavilla, Camilla; Kachelmeyer, Andrea; Placencia, Daisy Marty

doi:10.1001/jamanetworkopen.2021.42322

Cited by 38 publications

(30 citation statements)

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“…ACE2 expression is decreased in children with diabetes mellitus likely due to glycosylation ( 38 ), which may explain their higher risk for hospital or ICU admission in this and other series ( 33 ). Although asthma has been suggested as a risk factor for severe illness in children with COVID-19, our study, as well as a registry-based ( 39 ) and a cohort study ( 16 ) did not confirm this association. Overall, the underlying medical conditions associated with hospital or ICU admission in this Latin American pediatric registry are similar to those described for the same outcomes in US children ( 39 ).…”

Section: Discussioncontrasting

confidence: 93%

“…Early identification of factors associated with severe disease in children allows clinicians and public health officials to triage those in need of advanced level of care and is critical as vaccination campaigns are rolled out, allowing the prioritization of those who will benefit the most from early protection. Although several observational studies have provided information on risk factors for hospitalization or critical care admission in children in high-income countries ( 10 – 16 ), detailed demographic, laboratory, radiological and clinical data obtained from a large sample in LMIC countries are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America

et al. 2022

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BackgroundLimited data is available from low-middle and upper-middle income countries of the factors associated with hospitalization or admission to pediatric intensive care unit (PICU) for children with COVID-19.ObjectiveTo describe the factors associated with hospitalization or PICU admission of children with COVID-19 in Latin America.MethodMulticenter, analytical, retrospective study of children reported from 10 different Latin American countries to the Latin-American Society of Pediatric Infectious Diseases (SLIPE-COVID) research network from June 1, 2020, and February 28, 2021. Outpatient or hospitalized children <18 years of age with COVID-19 confirmed by polymerase chain reaction or antigen detection from the nasopharynx were included. Children with multisystem inflammatory syndrome in children (MIS-C) were excluded. Associations were assessed using univariate and multivariable logistic regression models.ResultsA total of 1063 children with COVID-19 were included; 500 (47%) hospitalized, with 419 (84%) to the pediatric wards and 81 (16%) to the ICU. In multivariable analyses, age <1 year (Odds Ratio [OR] 1.78; 95% CI 1.08–2.94), native race (OR 5.40; 95% CI 2.13–13.69) and having a co-morbid condition (OR 5.3; 95% CI 3.10–9.15), were associated with hospitalization. Children with metabolic or endocrine disorders (OR 4.22; 95% CI 1.76–10.11), immune deficiency (1.91; 95% CI 1.05–3.49), preterm birth (OR 2.52; 95% CI 1.41–4.49), anemia at presentation (OR 2.34; 95% CI 1.28–4.27), radiological peribronchial wall thickening (OR 2.59; 95% CI 1.15–5.84) and hypoxia, altered mental status, seizures, or shock were more likely to require PICU admission. The presence of pharyngitis (OR 0.34; 95% CI 0.25–0.48); myalgia (OR 0.47; 95% CI 0.28–0.79) or diarrhea (OR 0.38; 95% CI 0.21–0.67) were inversely associated with hospital admission.ConclusionsIn this data analysis reported to the SLIPE research network in Latin America, infants, social inequalities, comorbidities, anemia, bronchial wall thickening and specific clinical findings on presentation were associated with higher rates of hospitalization or PICU admission. This evidence provides data for prioritization prevention and treatment strategies for children suffering from COVID-19.

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Section: Discussioncontrasting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America

et al. 2022

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“…Comorbidities associated with severe COVID-19 include asthma, neurological disease, obesity, and diabetes [ 22 ]. For example, among 3221 SARS-CoV-2-positive children and adolescents enrolled in a global prospective cohort study with outcome data, 3.3% had severe outcomes within 14 days [ 23 ]. Tripathi and colleagues [ 24 ] analyzed data from 795 patients (96.4% in the United States) from 45 sites, including 251 (31.5%) with obesity.…”

Section: Discussionmentioning

confidence: 99%

How Comorbidities Affect Hospitalization from Influenza in the Pediatric Population

Mylonakis

Mylona

Kalligeros

et al. 2022

IJERPH

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Influenza is a contagious respiratory illness and can lead to hospitalization and even death. Understanding how comorbidities affect the severity of influenza can help clinical management. The aim of this study is to offer more information about comorbidities that might be associated with the severity of influenza in children. We used a statewide network in Rhode Island, USA, to extract data for laboratory-confirmed influenza cases among children 19 years old or younger. We identified 1169 lab-confirmed influenza cases. The most common comorbidities were asthma (17.1%), neurodevelopmental disorders (10.3%), gastrointestinal disorders (7.6%), atopic dermatitis (7%), and endocrine and metabolic diseases (6.8%). Interestingly, 80.8% (63 out of 78) of children who had an influenza-related hospital admission had at least one comorbidity, and among hospitalized children with influenza, the most common comorbidities were neurological diseases (28.2%, 22/78), gastrointestinal disorders (25.6%, 20/78), endocrine and metabolic diseases (24.4%, 19/78), and neurodevelopmental disorders (23.1%, 18/78). Children with endocrine or metabolic diseases were 8.23 times more likely to be admitted to the hospital, and children with neurological disorders were 6.35 times more likely to be admitted (OR: 8.23, 95% CI: 4.42–15.32 and OR: 6.35, 95% CI: 3.60–11.24, respectively). In summary, we identified specific comorbidities associated with influenza hospitalization and length of hospital stay, and these groups should be prioritized for public health interventions.

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“…Although mortality increases with age and the infection severity is linked to a wide range of local factors and age-related comorbidities [7, 15-19], it is wrong to conclude that COVID-19 is not harmful to young people. In particular, i) long-COVID (long-term effects of COVID-19) is a condition not uncommon in the younger age groups [21], and ii) the uncontrolled spread favors the appearance of variants of concern, capable of being much more dangerous even for the youngest (e.g., Delta and Omicron) [22]. Alongside this, joinpoint regression revealed growing mortality trends in almost all of Europe.…”

Section: Discussionmentioning

confidence: 99%

Joinpoint Regression to Determine the Impact of COVID-19 on Mortality in Europe: A Longitudinal Analysis From 2000 to 2020 in 27 Countries

Rovetta

2022

Preprint

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The novel coronavirus disease 2019 (COVID-19) represented the most extensive health emergency in human history. However, to date, there is still a lot of uncertainty about the exact death toll the pandemic has claimed. In particular, the number of official deaths could be vastly underestimated. Despite this, many conspirationists speculate that COVID-19 is not a dangerous disease. Therefore, in this manuscript, we use joinpoint regression analysis to estimate the impact of COVID-19 in 27 European countries by comparing annual mortality trends from 2000 to 2020. Furthermore, we provide accessible evidence even for a non-expert audience. In conclusion, our results estimate that COVID-19 increased the overall mortality in Europe by 10% (P < .001). In 16 out of 27 countries (59.3%), the excess mortality ranged from 7.4% to 18.5% (all P < .007). Comparison of the observed mortality distribution with the null counterfactual showed that the mortality increase was highly significant across Europe, even considering only the nations with minor 2020 increases (highest P = .014, lowest mean = 2.4).

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Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments

Cited by 38 publications

References 38 publications

Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America

Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America

How Comorbidities Affect Hospitalization from Influenza in the Pediatric Population

Joinpoint Regression to Determine the Impact of COVID-19 on Mortality in Europe: A Longitudinal Analysis From 2000 to 2020 in 27 Countries

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