COVID-19 Disease Characterization and Outcomes Comparison in Pediatrics

It has been reported that children experience less severe COVID-19 symptoms than adults; however, the literature that supports this idea is evolving. The purpose of this study was to retrospectively characterize hospitalized COVID-19-positive pediatric patients with a focus on the assessment of risk factors for poorer outcomes, mortality, and evaluation of interventions utilized and associated clinical outcomes.

We conducted a multi-center retrospective chart review of patients 18 years old or younger who were COVID-19 positive and admitted to any US HCA Healthcare Pediatric service line between January 1, 2020, and November 30, 2020. We identified 6081 children across 4 states and included them in our data analysis. Negative Binomial Regression was used to measure the associations between characteristics abstracted from medical records and length of hospital stay.

Of the total cohort, 2.7% had at least one comorbidity. The majority of patients were discharged shortly after admission with 93.6% of patients spending less than 48 hours as an inpatient. The mortality rate during the study period was 0.1%. Factors found to be significantly associated with an increased length of stay were time in the intensive care unit (ICU), surgeries, developmental disorders, diabetes, post-traumatic stress disorder (PTSD), suicidal ideation, and type of admission.

The results of this cohort show there was a low disease burden at baseline and during hospitalization in pediatric patients positive for COVID-19. However, as the pandemic continues, future studies that further describe COVID-19 in children will be crucial to fully understand the disease course.