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Factors Tied to Severe COVID-19 in Children Identified

TUESDAY, April 27, 2021 -- One in three children hospitalized with COVID-19 experience severe illness, which is associated with younger children, male patients, and those with a chronic condition, according to a research letter published online April 9 in JAMA Network Open.

Leigh Ellyn Preston, Dr.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues used data from the Premier Healthcare Database Special COVID-19 Release, an administrative all-payer database, to identify patients ages 18 years or younger with an inpatient or emergency department encounter with a primary or secondary COVID-19 discharge diagnosis (March 1 to Oct. 31, 2020).

The researchers identified 20,714 pediatric patients with COVID-19 (52.9 percent girls; 53.8 percent aged 12 to 18 years), of whom 39.3 percent were Hispanic or Latino individuals and 24.4 percent were non-Hispanic Black individuals. Nearly one in three of these young patients with COVID-19 had one or more chronic conditions (29.2 percent). Overall, 11.7 percent were hospitalized and one-third of those hospitalized (31.1 percent) experienced severe COVID-19. There was an association noted between severe COVID-19 and having one or more chronic conditions versus having none (adjusted odds ratio, 3.27). Furthermore, severe COVID-19 was more likely in hospitalized children aged 2 through 5 years or 6 through 11 years versus those aged 12 through 18 years (adjusted odds ratios, 1.53 and 1.53, respectively); this finding was also true for male versus female patients (adjusted odds ratio, 1.52). There was no significant association observed between race/ethnicity or insurance type and severe COVID-19.

"Reducing infection risk through community mitigation strategies is critical for protecting children from COVID-19 and preventing poor outcomes," the authors write.

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