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Risk of SARS-CoV-2 Infection and Hospitalisation in Immunocompromised Children: A Population-Based Cohort Study in

Costanza Di Chiara1,2,3, Riccardo Boracchini4, Nhung T H Trinh5

  • 1Department for Women's and Children's Health, University of Padua, Padua, Italy.

Acta Paediatrica (Oslo, Norway : 1992)
|March 23, 2026
PubMed

Insights

Immunocompromised children (IC) did not face higher SARS-CoV-2 infection risks. However, IC children showed increased hospitalisation rates, suggesting precautionary management rather than greater disease severity.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Immunocompromised children (IC) were presumed at higher risk for SARS-CoV-2 infection and severe COVID-19.
  • Limited population-based evidence exists regarding COVID-19 outcomes in pediatric populations with compromised immune systems.

Purpose of the Study:

  • To assess SARS-CoV-2 infection risk, COVID-19 hospitalization rates, and severe outcomes in immunocompromised children (IC) compared to children with other high-risk conditions (non-IC) and reference children (RC).

Main Methods:

  • Retrospective population-based cohort study utilizing electronic health registries from Italy and Norway (February 2020-February 2022).
  • Included children aged 1-14 years, classified into IC, non-IC, and RC groups.
  • Adjusted models were used to estimate infection and hospitalization risks.

Main Results:

  • Infection rates were similar across all groups in both countries.
  • Hospitalizations were rare overall. In Norway, adjusted hazard ratios for hospitalization were 5.29 (IC vs. RC) and 2.30 (IC vs. non-IC).
  • Severe COVID-19 cases were low (zero in Italy, five in Norway).

Conclusions:

  • Immunocompromised children (IC) did not exhibit an increased risk of SARS-CoV-2 infection.
  • IC children experienced higher hospitalization rates, potentially due to precautionary clinical management rather than increased disease severity.
  • The study highlights the need for careful monitoring and management strategies for immunocompromised children during viral outbreaks.
Abstract

Keywords:
COVID‐19 hospitalisationCOVID‐19 severitySARS‐CoV‐2 infectionimmunocompromised childrenpopulation‐based

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