Among a cohort of 20,714 US children with COVID-19, more than 1 in 10 were hospitalized, of whom 31.1% (756) had severe COVID-19, defined as requiring admission to the intensive care unit (ICU), mechanical ventilation, or comparable treatment. The study found that 2,430 (11.7%) of the 20,714 children who had an emergency department or inpatient encounter were hospitalized with COVID-19.
Discharge data from 869 US medical facilities from Mar 1 to Oct 31, 2020 showed that most hospitalized COVID pediatric patients were girls (52.8%) and 12 to 18 years of age (53.8%); 29.2% had at least one chronic condition. Similar to COVID studies in adult populations, Hispanic and Black populations were overrepresented at 39.3% and 24.4%, respectively. However, when the researchers looked at factors for severe COVID-19, race did not have any significant associations, and neither did insurance type.
The likelihood for severe COVID-19 increased if the patient had at least one chronic condition (adjusted odds ratio [aOR], 3.27; 95% confidence interval [CI], 2.44 to 4.37) or male (aOR, 1.52; 95% CI, 1.26 to 1.83). Likelihood also increased if the child was 2 to 5 or 6 to 11 years of age versus a teenager (aORs, 1.53 for both; 95% CIs, 1.11 to 2.13 and 1.04 to 2.23, respectively).
“Although admission to an intensive care unit for younger children may indicate an abundance of caution by clinicians or facility and administrative requirements rather than disease severity, this finding has important clinical and resource planning implications for facilities and clinicians,” the researchers write. “Understanding factors associated with severe COVID-19 disease among children could help inform prevention and control strategies.”