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Black-White Risk Differentials in Pediatric COVID-19 Hospitalization and Intensive Care Unit Admissions in the USA
Laurens Holmes1,2,3, Colin Wu4, Rakinya Hinson5,6
1Office of Health Equity and Inclusion (OHEI), Nemours Children's Healthcare System, Wilmington, DE, USA. drlholmesjr@gmail.com.
Insights
COVID-19 disproportionately affected Black/African American children, who were twice as likely to be hospitalized and over five times as likely to require ICU admission compared to White children. These findings highlight critical racial disparities in pediatric COVID-19 outcomes.
Area of Science:
- Epidemiology
- Public Health
- Pediatrics
Background:
- The COVID-19 pandemic caused severe illness in children, with notable racial disparities in outcomes.
- Understanding these disparities is crucial for addressing health inequities.
Purpose of the Study:
- To assess racial differences in COVID-19 cumulative incidence, hospitalization, and intensive care unit (ICU) admission among children in the US.
- To identify specific racial groups disproportionately affected by severe COVID-19 manifestations.
Main Methods:
- A cross-sectional epidemiological study using 2020 pediatric COVID-19 data from the CDC.
- Chi-square statistics and binomial regression models were employed to analyze racial differentials in hospitalization and ICU admissions.
Main Results:
- Over 96,000 pediatric hospitalizations and 12,000 ICU admissions were recorded.
- Black/African American children showed a 2.20 times higher likelihood of hospitalization and a 5.18 times higher likelihood of ICU admission compared to White children.
- Asian children had a 1.45 times higher hospitalization risk and a 3.36 times higher ICU admission risk. American Indian/Alaska Native children also faced increased ICU admission risk (2.54 times).
Conclusions:
- Significant racial disparities exist in pediatric COVID-19 hospitalization and ICU admission rates in the US.
- Black/African American children are disproportionately impacted, underscoring the need for health equity interventions.
Purpose:
The COVID-19 morbidity with SARS-CoV-2 as a causative pathogenic microbe remains a pandemic with children experiencing less mortality but with severe manifestations. The current study aimed to assess SARS-CoV-2 cumulative incidence, COVID-19 hospitalization, and ICU admission with respect to racial differentials.
Materials And Methods:
A cross-sectional nonexperimental epidemiologic design was used to examine pediatric COVID-19 data from CDC during 2020. The variables assessed were ICU admissions, hospitalization, sex, race, and region. The Chi-Square (X2) statistic was used to examine the independence of the variables by race, while the binomial regression model was used to predict racial risk differentials in hospitalization and ICU admissions.
Results:
The pediatric COVID-19 data observed the cumulative incidence of hospitalization to be 96,376, while ICU admission was 12,448. Racial differences were observed in hospitalization, ICU admissions, sex, and region. With respect to COVID-19 hospitalization, Black/African American (AA) children were two times as likely to be hospitalized compared to their White counterparts, prevalence risk ratio (pRR) = 2.20, 99% confidence interval (CI = 2.12-2.28). Similarly, Asians were 45% more likely to be hospitalized relative to their White counterparts, pRR = 1.45, 99% CI = 1.32-1.60. Regarding ICU admission, there was a disproportionate racial burden, implying excess ICU admission among Black/AA children relative to their White counterparts, pRR = 5.18, 99% CI = 4.44-6.04. Likewise, Asian children were 3 times as likely to be admitted to the ICU compared to their White counterparts, pRR = 3.36, 99% CI = 2.37-4.77. Additionally, American Indians/Alaska Natives were 2 times as likely to be admitted to ICU, pRR = 2.54, 99% CI = 0.82-7.85.
Conclusion:
Racial disparities were observed in COVID-19 hospitalization and ICU admission among the US children, with Black/AA children being disproportionately affected, implying health equity transformation.
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