Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data

Area of Science:

• Pediatric Critical Care Medicine
• Infectious Diseases
• Epidemiology

Background:

• The COVID-19 pandemic significantly impacted healthcare systems, particularly intensive care units.
• Pediatric intensive care unit (PICU) data regarding COVID-19 admissions is limited.
• Understanding factors influencing pediatric COVID-19 admissions is crucial for resource allocation and patient management.

Purpose of the Study:

• To characterize COVID-19 positive admissions (CPAs) in U.S. PICUs.
• To identify factors associated with CPA frequency and severity.
• To inform future research and clinical practice for pediatric COVID-19 patients.

Main Methods:

• Retrospective cohort study utilizing the COVID-19 Virtual Pediatric System (VPS) dashboard.
• Analysis of state-level data including population density, comorbidities, and social distancing scores.
• Univariate and multivariate regression analyses to assess associations between CPA frequency and admission outcomes.

Main Results:

• A total of 205 CPAs were reported across 48 states, with an estimated frequency of 2.8 per million children.
• Children over 11 years old and those with comorbidities (35.1%) were frequently admitted.
• Higher population density was associated with increased CPAs; pediatric type 1 diabetes mellitus correlated with longer mechanical ventilation and intubation durations.

Conclusions:

• Inpatient mortality for pediatric COVID-19 positive admissions in PICUs is low (1.4%).
• Population density appears to be a significant factor influencing CPA frequency.
• Type 1 diabetes mellitus is associated with increased need for advanced respiratory support and prolonged intubation in pediatric COVID-19 patients.