Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19

Rewa Choudhary; Bryant J. Webber; Lindsay S. Womack; Hannah K. Dupont; Sophia K. Chiu; Valentine Wanga; Megan E. Gerdes; Sophia Hsu; Dallas S. Shi; Theresa M. Dulski; Osatohamwen I. Idubor; Arthur M. Wendel; Nickolas T. Agathis; Kristi Anderson; Tricia Boyles; Eleanor S. Click; Juliana Da Silva; Mary E. Evans; Jeremy A.W. Gold; Julia C. Haston; Pamela Logan; Susan A. Maloney; Marisol Martinez; Pavithra Natarajan; Kevin B. Spicer; Mark Swancutt; Valerie A. Stevens; Jessica Rogers-Brown; Gyan Chandra; Megan Light; Frederick E. Barr; Jessica Snowden; Larry K. Kociolek; Matthew McHugh; David L. Wessel; Joelle N. Simpson; Kathleen C. Gorman; Kristen A. Breslin; Roberta L. DeBiasi; Aaron Thompson; Mark W. Kline; Julie A. Boom; Ila R. Singh; Michael Dowlin; Mark Wietecha; Beth Schweitzer; Sapna Bamrah Morris; Emilia H. Koumans; Jean Y. Ko; David A. Siegel; Anne A. Kimball

doi:10.1542/hpeds.2022-006613

Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19

Rewa Choudhary, Bryant J. Webber, Lindsay S. Womack, Hannah K. Dupont, Sophia K. Chiu, Valentine Wanga, Megan E. Gerdes, Sophia Hsu, Dallas S. Shi, Theresa M. Dulski, Osatohamwen I. Idubor, Arthur M. Wendel, Nickolas T. Agathis, Kristi Anderson, Tricia Boyles, Eleanor S. Click, Juliana Da Silva, Mary E. Evans, Jeremy A.W. Gold, Julia C. HastonPamela Logan, Susan A. Maloney, Marisol Martinez, Pavithra Natarajan, Kevin B. Spicer, Mark Swancutt, Valerie A. Stevens, Jessica Rogers-Brown, Gyan Chandra, Megan Light, Frederick E. Barr, Jessica Snowden, Larry K. Kociolek, Matthew McHugh, David L. Wessel, Joelle N. Simpson, Kathleen C. Gorman, Kristen A. Breslin, Roberta L. DeBiasi, Aaron Thompson, Mark W. Kline, Julie A. Boom, Ila R. Singh, Michael Dowlin, Mark Wietecha, Beth Schweitzer, Sapna Bamrah Morris, Emilia H. Koumans, Jean Y. Ko, David A. Siegel, Anne A. Kimball

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

OBJECTIVES: To describe coronavirus disease 2019 (COVID-19)-related pediatric hospitalizations during a period of B.1.617.2 (D) variant predominance and to determine age-specific factors associated with severe illness. METHODS: We abstracted data from medical charts to conduct a cross-sectional study of patients aged <21 years hospitalized at 6 United States children's hospitals from July to August 2021 for COVID-19 or with an incidental positive severe acute respiratory syndrome coronavirus 2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation. RESULTS: Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with respiratory syncytial virus (RSV) (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1 to 4 years (PR 1.96); and obesity in patients aged 5 to 11 (PR 2.20) and 12 to 17 years (PR 2.48). Having $2 underlying medical conditions was associated with severe illness in patients aged <1 (PR 1.82), 5 to 11 (PR 3.72), and 12 to 17 years (PR 3.19). CONCLUSIONS: Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged <5 years, obesity in those aged 5 to 17 years, and other underlying conditions for all age groups <18 years. These findings can inform pediatric practice, risk communication, and prevention strategies, including vaccination against COVID-19.

Original language	English (US)
Pages (from-to)	760-771
Number of pages	12
Journal	Hospital Pediatrics
Volume	12
Issue number	9
DOIs	https://doi.org/10.1542/hpeds.2022-006613
State	Published - Sep 2022
Externally published	Yes

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Pediatrics

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10.1542/hpeds.2022-006613

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Choudhary, R., Webber, B. J., Womack, L. S., Dupont, H. K., Chiu, S. K., Wanga, V., Gerdes, M. E., Hsu, S., Shi, D. S., Dulski, T. M., Idubor, O. I., Wendel, A. M., Agathis, N. T., Anderson, K., Boyles, T., Click, E. S., Da Silva, J., Evans, M. E., Gold, J. A. W., ... Kimball, A. A. (2022). Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19. Hospital Pediatrics, 12(9), 760-771. https://doi.org/10.1542/hpeds.2022-006613

Choudhary, R, Webber, BJ, Womack, LS, Dupont, HK, Chiu, SK, Wanga, V, Gerdes, ME, Hsu, S, Shi, DS, Dulski, TM, Idubor, OI, Wendel, AM, Agathis, NT, Anderson, K, Boyles, T, Click, ES, Da Silva, J, Evans, ME, Gold, JAW, Haston, JC, Logan, P, Maloney, SA, Martinez, M, Natarajan, P, Spicer, KB, Swancutt, M, Stevens, VA, Rogers-Brown, J, Chandra, G, Light, M, Barr, FE, Snowden, J, Kociolek, LK, McHugh, M, Wessel, DL, Simpson, JN, Gorman, KC, Breslin, KA, DeBiasi, RL, Thompson, A, Kline, MW, Boom, JA, Singh, IR, Dowlin, M, Wietecha, M, Schweitzer, B, Morris, SB, Koumans, EH, Ko, JY, Siegel, DA & Kimball, AA 2022, 'Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19', Hospital Pediatrics, vol. 12, no. 9, pp. 760-771. https://doi.org/10.1542/hpeds.2022-006613

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title = "Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19",

abstract = "OBJECTIVES: To describe coronavirus disease 2019 (COVID-19)-related pediatric hospitalizations during a period of B.1.617.2 (D) variant predominance and to determine age-specific factors associated with severe illness. METHODS: We abstracted data from medical charts to conduct a cross-sectional study of patients aged <21 years hospitalized at 6 United States children's hospitals from July to August 2021 for COVID-19 or with an incidental positive severe acute respiratory syndrome coronavirus 2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation. RESULTS: Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with respiratory syncytial virus (RSV) (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1 to 4 years (PR 1.96); and obesity in patients aged 5 to 11 (PR 2.20) and 12 to 17 years (PR 2.48). Having $2 underlying medical conditions was associated with severe illness in patients aged <1 (PR 1.82), 5 to 11 (PR 3.72), and 12 to 17 years (PR 3.19). CONCLUSIONS: Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged <5 years, obesity in those aged 5 to 17 years, and other underlying conditions for all age groups <18 years. These findings can inform pediatric practice, risk communication, and prevention strategies, including vaccination against COVID-19.",

author = "Rewa Choudhary and Webber, {Bryant J.} and Womack, {Lindsay S.} and Dupont, {Hannah K.} and Chiu, {Sophia K.} and Valentine Wanga and Gerdes, {Megan E.} and Sophia Hsu and Shi, {Dallas S.} and Dulski, {Theresa M.} and Idubor, {Osatohamwen I.} and Wendel, {Arthur M.} and Agathis, {Nickolas T.} and Kristi Anderson and Tricia Boyles and Click, {Eleanor S.} and {Da Silva}, Juliana and Evans, {Mary E.} and Gold, {Jeremy A.W.} and Haston, {Julia C.} and Pamela Logan and Maloney, {Susan A.} and Marisol Martinez and Pavithra Natarajan and Spicer, {Kevin B.} and Mark Swancutt and Stevens, {Valerie A.} and Jessica Rogers-Brown and Gyan Chandra and Megan Light and Barr, {Frederick E.} and Jessica Snowden and Kociolek, {Larry K.} and Matthew McHugh and Wessel, {David L.} and Simpson, {Joelle N.} and Gorman, {Kathleen C.} and Breslin, {Kristen A.} and DeBiasi, {Roberta L.} and Aaron Thompson and Kline, {Mark W.} and Boom, {Julie A.} and Singh, {Ila R.} and Michael Dowlin and Mark Wietecha and Beth Schweitzer and Morris, {Sapna Bamrah} and Koumans, {Emilia H.} and Ko, {Jean Y.} and Siegel, {David A.} and Kimball, {Anne A.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 by the American Academy of Pediatrics.",

year = "2022",

month = sep,

doi = "10.1542/hpeds.2022-006613",

language = "English (US)",

volume = "12",

pages = "760--771",

journal = "Hospital Pediatrics",

issn = "2154-1663",

publisher = "American Academy of Pediatrics",

number = "9",

}

TY - JOUR

T1 - Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19

AU - Choudhary, Rewa

AU - Webber, Bryant J.

AU - Womack, Lindsay S.

AU - Dupont, Hannah K.

AU - Chiu, Sophia K.

AU - Wanga, Valentine

AU - Gerdes, Megan E.

AU - Hsu, Sophia

AU - Shi, Dallas S.

AU - Dulski, Theresa M.

AU - Idubor, Osatohamwen I.

AU - Wendel, Arthur M.

AU - Agathis, Nickolas T.

AU - Anderson, Kristi

AU - Boyles, Tricia

AU - Click, Eleanor S.

AU - Da Silva, Juliana

AU - Evans, Mary E.

AU - Gold, Jeremy A.W.

AU - Haston, Julia C.

AU - Logan, Pamela

AU - Maloney, Susan A.

AU - Martinez, Marisol

AU - Natarajan, Pavithra

AU - Spicer, Kevin B.

AU - Swancutt, Mark

AU - Stevens, Valerie A.

AU - Rogers-Brown, Jessica

AU - Chandra, Gyan

AU - Light, Megan

AU - Barr, Frederick E.

AU - Snowden, Jessica

AU - Kociolek, Larry K.

AU - McHugh, Matthew

AU - Wessel, David L.

AU - Simpson, Joelle N.

AU - Gorman, Kathleen C.

AU - Breslin, Kristen A.

AU - DeBiasi, Roberta L.

AU - Thompson, Aaron

AU - Kline, Mark W.

AU - Boom, Julie A.

AU - Singh, Ila R.

AU - Dowlin, Michael

AU - Wietecha, Mark

AU - Schweitzer, Beth

AU - Morris, Sapna Bamrah

AU - Koumans, Emilia H.

AU - Ko, Jean Y.

AU - Siegel, David A.

AU - Kimball, Anne A.

PY - 2022/9

Y1 - 2022/9

N2 - OBJECTIVES: To describe coronavirus disease 2019 (COVID-19)-related pediatric hospitalizations during a period of B.1.617.2 (D) variant predominance and to determine age-specific factors associated with severe illness. METHODS: We abstracted data from medical charts to conduct a cross-sectional study of patients aged <21 years hospitalized at 6 United States children's hospitals from July to August 2021 for COVID-19 or with an incidental positive severe acute respiratory syndrome coronavirus 2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation. RESULTS: Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with respiratory syncytial virus (RSV) (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1 to 4 years (PR 1.96); and obesity in patients aged 5 to 11 (PR 2.20) and 12 to 17 years (PR 2.48). Having $2 underlying medical conditions was associated with severe illness in patients aged <1 (PR 1.82), 5 to 11 (PR 3.72), and 12 to 17 years (PR 3.19). CONCLUSIONS: Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged <5 years, obesity in those aged 5 to 17 years, and other underlying conditions for all age groups <18 years. These findings can inform pediatric practice, risk communication, and prevention strategies, including vaccination against COVID-19.

AB - OBJECTIVES: To describe coronavirus disease 2019 (COVID-19)-related pediatric hospitalizations during a period of B.1.617.2 (D) variant predominance and to determine age-specific factors associated with severe illness. METHODS: We abstracted data from medical charts to conduct a cross-sectional study of patients aged <21 years hospitalized at 6 United States children's hospitals from July to August 2021 for COVID-19 or with an incidental positive severe acute respiratory syndrome coronavirus 2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation. RESULTS: Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with respiratory syncytial virus (RSV) (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1 to 4 years (PR 1.96); and obesity in patients aged 5 to 11 (PR 2.20) and 12 to 17 years (PR 2.48). Having $2 underlying medical conditions was associated with severe illness in patients aged <1 (PR 1.82), 5 to 11 (PR 3.72), and 12 to 17 years (PR 3.19). CONCLUSIONS: Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged <5 years, obesity in those aged 5 to 17 years, and other underlying conditions for all age groups <18 years. These findings can inform pediatric practice, risk communication, and prevention strategies, including vaccination against COVID-19.

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Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19

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