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Severity of SARS-CoV-2 infection in a hospital population: a clinical comparison across age groups

Chiara Rosazza1, Laura Alagna2, Alessandra Bandera2,3

  • 1Paediatric Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Italian Journal of Pediatrics
|October 8, 2023
PubMed

Insights

COVID-19 (coronavirus disease 2019) is generally less severe in children compared to adults. While rare, multisystem inflammatory syndrome in children (MIS-C) is a serious complication, and its risk factors remain unknown.

Area of Science:

  • Infectious Diseases
  • Pediatrics
  • Epidemiology

Background:

  • Children typically experience milder COVID-19 (coronavirus disease 2019) than adults.
  • However, post-acute complications of SARS-CoV-2 infection have been noted in pediatric populations.
  • This study investigates COVID-19 outcomes and long-term complications in children versus adults.

Purpose of the Study:

  • To compare COVID-19-related outcomes and long-term complications between pediatric and adult patients.
  • To assess the severity of SARS-CoV-2 infection across different age groups.
  • To determine the relative risk of severe COVID-19 outcomes, including hospitalization and need for supplemental oxygen.

Main Methods:

  • Prospective, multicentre study (DECO COVID-19) including 154 individuals with RT-PCR-confirmed SARS-CoV-2 infection.
  • Comparison of COVID-19 severity across three age groups: children/adolescents (<18 years), young/middle-aged adults (18-64 years), and older adults.
  • Log-binomial models were used to estimate the relative risk (RR) of severe COVID-19, defined by hospitalization and/or supplemental oxygen requirement.

Main Results:

  • Children/adolescents (84) had a lower risk of hospitalization (RR: 0.49) and supplemental oxygen need (RR: 0.12) compared to young/middle-aged adults.
  • Older adults showed a higher risk of hospitalization (RR: 1.52) and supplemental oxygen need (RR: 1.46).
  • Three children developed multisystem inflammatory syndrome (MIS-C); none required intensive care or reported post-acute complications.

Conclusions:

  • COVID-19 (coronavirus disease 2019) is confirmed to be less severe in the pediatric population.
  • Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe complication of SARS-CoV-2 infection.
  • Risk factors for MIS-C in children are currently unknown and require further investigation.
Abstract

Keywords:
COVID-19MIS-COutcomePaediatric populationSARS-CoV-2 infection

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