Thirty-Day Outcomes of Children and Adolescents With COVID-19 : An International Experience

Copyright © 2021 by the American Academy of Pediatrics..

OBJECTIVES: To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children and adolescents diagnosed or hospitalized with coronavirus disease 2019 (COVID-19) and to compare them in secondary analyses with patients diagnosed with previous seasonal influenza in 2017-2018.

METHODS: International network cohort using real-world data from European primary care records (France, Germany, and Spain), South Korean claims and US claims, and hospital databases. We included children and adolescents diagnosed and/or hospitalized with COVID-19 at age <18 between January and June 2020. We described baseline demographics, comorbidities, symptoms, 30-day in-hospital treatments, and outcomes including hospitalization, pneumonia, acute respiratory distress syndrome, multisystem inflammatory syndrome in children, and death.

RESULTS: A total of 242 158 children and adolescents diagnosed and 9769 hospitalized with COVID-19 and 2 084 180 diagnosed with influenza were studied. Comorbidities including neurodevelopmental disorders, heart disease, and cancer were more common among those hospitalized with versus diagnosed with COVID-19. Dyspnea, bronchiolitis, anosmia, and gastrointestinal symptoms were more common in COVID-19 than influenza. In-hospital prevalent treatments for COVID-19 included repurposed medications (<10%) and adjunctive therapies: systemic corticosteroids (6.8%-7.6%), famotidine (9.0%-28.1%), and antithrombotics such as aspirin (2.0%-21.4%), heparin (2.2%-18.1%), and enoxaparin (2.8%-14.8%). Hospitalization was observed in 0.3% to 1.3% of the cohort diagnosed with COVID-19, with undetectable (n < 5 per database) 30-day fatality. Thirty-day outcomes including pneumonia and hypoxemia were more frequent in COVID-19 than influenza.

CONCLUSIONS: Despite negligible fatality, complications including hospitalization, hypoxemia, and pneumonia were more frequent in children and adolescents with COVID-19 than with influenza. Dyspnea, anosmia, and gastrointestinal symptoms could help differentiate diagnoses. A wide range of medications was used for the inpatient management of pediatric COVID-19.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

Pediatrics - Vol. 148, No. 3 (2021)

Language:

English

Contributors:

Duarte-Salles, Talita
Vizcaya, David
Pistillo, Andrea
Casajust, Paula
Sena, Anthony G
Lai, Lana Yin Hui
Prats-Uribe, Albert
Ahmed, Waheed-Ul-Rahman
Alshammari, Thamir M
Alghoul, Heba
Alser, Osaid
Burn, Edward
You, Seng Chan
Areia, Carlos
Blacketer, Clair
DuVall, Scott
Falconer, Thomas
Fernandez-Bertolin, Sergio
Fortin, Stephen
Golozar, Asieh
Gong, Mengchun
Tan, Eng Hooi
Huser, Vojtech
Iveli, Pablo
Morales, Daniel R
Nyberg, Fredrik
Posada, Jose D
Recalde, Martina
Roel, Elena
Schilling, Lisa M
Shah, Nigam H
Shah, Karishma
Suchard, Marc A
Zhang, Lin
Zhang, Ying
Williams, Andrew E
Reich, Christian G
Hripcsak, George
Rijnbeek, Peter
Ryan, Patrick
Kostka, Kristin
Prieto-Alhambra, Daniel

Links:

Volltext

Keywords:

*COVID-19
Adolescent
Age Distribution
Child
Child, Preschool
Cohort Studies
Comorbidity
Comparative Study
Databases, Factual
Diagnosis, Differential
Female
France
Germany
Hospitalization
Humans
Infant
Infant, Newborn
Influenza, Human
Journal Article
Male
Republic of Korea
Research Support, Non-U.S. Gov't
Spain
Symptom Assessment
Time Factors
Treatment Outcome
United States

Notes:

Date Completed 10.09.2021

Date Revised 10.09.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1542/peds.2020-042929

PMID:

34049958

PPN (Catalogue-ID):

NLM32713870X