Risk Factors for Severe COVID-19 in Children

被引：213

作者：

Woodruff, Rebecca C. ^{[1
,2
]}

Campbell, Angela P. ^{[1
]}

Taylor, Christopher A. ^{[1
]}

Chai, Shua J. ^{[3
,4
]}

Kawasaki, Breanna ^{[5
]}

Meek, James ^{[6
]}

Anderson, Evan J. ^{[7
,8
,9
,10
]}

Weigel, Andy ^{[11
]}

Monroe, Maya L. ^{[12
]}

Reeg, Libby ^{[13
]}

Bye, Erica ^{[14
]}

Sosin, Daniel M. ^{[15
,16
]}

Muse, Alison ^{[17
]}

Bennett, Nancy M. ^{[18
]}

Billing, Laurie M. ^{[19
]}

Sutton, Melissa ^{[20
]}

Talbot, H. Keipp ^{[21
]}

McCaffrey, Keegan ^{[22
]}

Pham, Huong ^{[1
]}

Patel, Kadam ^{[1
,23
]}

Whitaker, Michael ^{[1
]}

McMorrow, Meredith L. ^{[1
,2
]}

Havers, Fiona P. ^{[1
,2
]}

机构：

[1] Ctr Dis Control & Prevent, Coronavirus Dis 2019 Associated Hospitalizat Surv, Div Viral Dis, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA

[2] US Publ Hlth Serv Commissioned Corps, Rockville, MD USA

[3] Ctr Dis Control & Prevent, Div State & Local Readiness, Ctr Preparedness & Response, Atlanta, GA USA

[4] Calif Emerging Infect Program, Oakland, CA USA

[5] Colorado Dept Publ Hlth & Environm, Denver, CO USA

[6] Yale Sch Publ Hlth, Connecticut Emerging Infect Program, New Haven, CT USA

[7] Emory Sch Med, Dept Med, Atlanta, GA USA

[8] Emory Sch Med, Dept Pediat, Atlanta, GA USA

[9] Georgia Dept Publ Hlth, Georgia Emerging Infect Program, Atlanta, GA USA

[10] Atlanta Vet Affairs Med Ctr, Atlanta, GA USA

[11] Iowa Dept Publ Hlth, Des Moines, IA 50319 USA

[12] Maryland Dept Hlth, Baltimore, MD USA

[13] Michigan Dept Hlth & Human Serv, Lansing, MI USA

[14] Minnesota Dept Hlth, St Paul, MN USA

[15] New Mexico Emerging Infect Program, Santa Fe, NM USA

[16] New Mexico Dept Hlth, Santa Fe, NM USA

[17] New York State Dept Hlth, Albany, NY USA

[18] Univ Rochester, Sch Med & Dent, Rochester, NY USA

[19] Ohio Dept Hlth, Columbus, OH 43266 USA

[20] Oregon Hlth Author, Publ Hlth Div, Portland, OR USA

[21] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[22] Utah Dept Hlth, Salt Lake City, UT 84116 USA

[23] Gen Dynam Informat Technol, Atlanta, GA USA

来源：

PEDIATRICS | 2022年 / 149卷 / 01期

关键词：

PRACTICES INTERIM RECOMMENDATION; ADVISORY-COMMITTEE; UNITED-STATES; VACCINE; DISEASE;

D O I：

10.1542/peds.2021-053418

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

OBJECTIVES: Describe population-based rates and risk factors for pediatric severe coronavirus abstract disease 2019 (COVID-19) (ie, ICU admission, invasive mechanical ventilation, or death). METHODS: During March 2020 to May 2021, the COVID-19-Associated Hospitalization Surveillance Network identified 3106 children hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in 14 states. Among 2293 children primarily admitted for COVID-19, multivariable generalized estimating equations generated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) of the associations between demographic and medical characteristics abstracted from patient electronic medical records and severe COVID-19. We calculated age-adjusted cumulative population-based rates of severe COVID-19 among all children. RESULTS: Approximately 30% of hospitalized children had severe COVID-19; 0.5% died during hospitalization. Among hospitalized children aged <2 years, chronic lung disease (aRR: 2.2; 95% CI: 1.1-4.3), neurologic disorders (aRR: 2.0; 95% CI: 1.5-2.6), cardiovascular disease (aRR: 1.7; 95% CI: 1.2-2.3), prematurity (aRR: 1.6; 95% CI: 1.1-2.2), and airway abnormality (aRR: 1.6; 95% CI: 1.1-2.2) were associated with severe COVID-19. Among hospitalized children aged 2 to 17 years, feeding tube dependence (aRR: 2.0; 95% CI: 1.5-2.5), diabetes mellitus (aRR: 1.9; 95% CI: 1.6-2.3) and obesity (aRR: 1.2; 95% CI: 1.0-1.4) were associated with severe COVID-19. Severe COVID-19 occurred among 12.0 per 100 000 children overall and was highest among infants, Hispanic children, and non-Hispanic Black children. CONCLUSIONS: Results identify children at potentially higher risk of severe COVID-19 who may benefit from prevention efforts, including vaccination. Rates establish a baseline for monitoring changes in pediatric illness severity after increased availability of COVID-19 vaccines and the emergence of new variants.

引用

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