Related Experiment Video
Updated: Dec 21, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and
Lara S Shekerdemian1, Nabihah R Mahmood2, Katie K Wolfe3
1Texas Children's Hospital, Baylor College of Medicine, Houston.
Insights
Severe coronavirus disease 2019 (COVID-19) in children admitted to pediatric intensive care units (PICUs) is significant but less frequent than in adults. Preexisting comorbidities were common in pediatric COVID-19 patients, influencing disease severity.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Epidemiology
Background:
- The coronavirus disease 2019 (COVID-19) pandemic has severely impacted adult critical care, with limited data on pediatric intensive care unit (PICU) admissions.
- Early characterization of COVID-19 in North American PICUs is crucial for understanding disease burden in children.
Purpose of the Study:
- To describe and characterize COVID-19 infection in North American PICUs.
- Focus on presentation, comorbidities, disease severity, treatments, and outcomes in pediatric patients.
Main Methods:
- Cross-sectional study of children with confirmed COVID-19 admitted to 46 North American PICUs.
- Data collected from March 14 to April 10, 2020, including prehospital characteristics and clinical trajectory.
Main Results:
- 48 children admitted; 52% male, median age 13 years. 83% had comorbidities.
- 38% required invasive ventilation, 23% experienced 2+ organ system failures.
- 4% mortality; 31% still hospitalized at follow-up. Hydroxychloroquine was a common therapy.
Conclusions:
- COVID-19 severe illness in children is significant but less common than in adults.
- Prehospital comorbidities are an important factor in pediatric COVID-19 severity.
- This study provides a foundation for larger investigations into pediatric COVID-19.
Importance:
The recent and ongoing coronavirus disease 2019 (COVID-19) pandemic has taken an unprecedented toll on adults critically ill with COVID-19 infection. While there is evidence that the burden of COVID-19 infection in hospitalized children is lesser than in their adult counterparts, to date, there are only limited reports describing COVID-19 in pediatric intensive care units (PICUs).
Objective:
To provide an early description and characterization of COVID-19 infection in North American PICUs, focusing on mode of presentation, presence of comorbidities, severity of disease, therapeutic interventions, clinical trajectory, and early outcomes.
Design, Setting, And Participants:
This cross-sectional study included children positive for COVID-19 admitted to 46 North American PICUs between March 14 and April 3, 2020. with follow-up to April 10, 2020.
Main Outcomes And Measures:
Prehospital characteristics, clinical trajectory, and hospital outcomes of children admitted to PICUs with confirmed COVID-19 infection.
Results:
Of the 48 children with COVID-19 admitted to participating PICUs, 25 (52%) were male, and the median (range) age was 13 (4.2-16.6) years. Forty patients (83%) had significant preexisting comorbidities; 35 (73%) presented with respiratory symptoms and 18 (38%) required invasive ventilation. Eleven patients (23%) had failure of 2 or more organ systems. Extracorporeal membrane oxygenation was required for 1 patient (2%). Targeted therapies were used in 28 patients (61%), with hydroxychloroquine being the most commonly used agent either alone (11 patients) or in combination (10 patients). At the completion of the follow-up period, 2 patients (4%) had died and 15 (31%) were still hospitalized, with 3 still requiring ventilatory support and 1 receiving extracorporeal membrane oxygenation. The median (range) PICU and hospital lengths of stay for those who had been discharged were 5 (3-9) days and 7 (4-13) days, respectively.
Conclusions And Relevance:
This early report describes the burden of COVID-19 infection in North American PICUs and confirms that severe illness in children is significant but far less frequent than in adults. Prehospital comorbidities appear to be an important factor in children. These preliminary observations provide an important platform for larger and more extensive studies of children with COVID-19 infection.
