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Hospital and ICU Admission Risk Associated With Comorbidities Among Children With COVID-19 Ancestral Strains
Stephanie P Ungar1, Sadie Solomon2, Anna Stachel2
1Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
Clinical Pediatrics
|January 20, 2023
Summary
Children with COVID-19 and existing health conditions face higher risks of hospitalization and intensive care unit (ICU) admission. These comorbidities significantly increase the likelihood of severe outcomes in pediatric COVID-19 cases.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of viral infections
- Public health and child welfare
Background:
- COVID-19 significantly impacts children, necessitating an understanding of risk factors for severe illness.
- Previous research has highlighted varying risks, but specific comorbidity associations in pediatric COVID-19 require further elucidation.
Purpose of the Study:
- To investigate the association between pre-existing comorbidities and the risk of hospitalization and intensive care unit (ICU) admission in children with symptomatic COVID-19.
- To identify specific comorbidities that elevate the risk of severe COVID-19 outcomes in pediatric populations.
Main Methods:
- Retrospective cohort study analyzing data from 4097 children under 21 with symptomatic COVID-19 across two large health systems (March 2020 - September 2021).
- Utilized univariable and multivariable logistic regression analyses to compare outcomes between children with and without comorbidities, adjusting for demographic factors.
Main Results:
- 11.6% of children were hospitalized, with 25.5% of those requiring ICU admission. Infants under 1 year had high hospitalization but low ICU risk.
- The presence of any comorbidity significantly increased hospitalization and ICU admission risk (odds ratio [OR] > 4).
- Specific comorbidities like asthma, obesity, chronic kidney disease, sickle cell disease, neurologic disorders, malignancy, intellectual disability, and prematurity were associated with increased hospitalization or ICU admission.
Conclusions:
- Comorbidities are a significant risk factor for severe COVID-19 outcomes, including hospitalization and ICU admission, in children.
- Identifying children with specific comorbidities is crucial for risk stratification and management of pediatric COVID-19 cases.
- Public health strategies should consider the impact of comorbidities on pediatric COVID-19 severity.
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