Factors associated with hospital and intensive care admission in paediatric SARS-CoV-2 infection : a prospective nationwide observational cohort study
© 2021. The Author(s)..
Coronavirus disease 2019 (COVID-19) is usually less severe in children compared to adults. This study describes detailed clinical characteristics, treatment and outcomes of children with COVID-19 in a non-hospitalised and hospitalised setting and quantifies factors associated with admission to hospital and intensive care unit in children with SARS-CoV-2 infection on a nationwide level. Data were collected through the Swiss Paediatric Surveillance Unit from children < 18 years with confirmed SARS-CoV-2 infection. All 33 paediatric hospitals in Switzerland reported non-hospitalised and hospitalised cases from March 1 to October 31, 2020 during both pandemic peaks. In total, 678 children were included. The median age was 12.2 years (IQR 5.0-14.6), 316 (46.6%) were female and 106 (15.6%) had comorbidities. Overall, 126 (18.6%) children were hospitalised of whom 16 (12.7%) required ICU admission. Comorbidities were the only factor associated with hospital admission in a multivariable regression analysis (odds ratio 3.23, 95%CI 1.89 to 5.50; p-value < 0.01). Children with preexisting comorbidities did not require ICU admission more often. Hospitalised children more often presented with fever (96 [76.2%] vs 209 [38.1%], p-value < 0.01) and rash (16 [12.8%] vs 6 [1.1%], p-value < 0.01). Anosmia/dysgeusia was more prevalent in non-hospitalised children (73 [13.3%] vs 3 [2.4%], p-value < 0.01). In hospitalised children, oxygen treatment was required in 34 (27.0%), inotropes in nine (7.3%) and mechanical ventilation in eight (6.3%) cases. Complications were reported in 28 (4.1%) children with cardiovascular complications being most frequent (12 [1.8%]). Three deaths were recorded.Conclusion: This study confirms that COVID-19 is mostly a mild disease in children. Fever, rash and comorbidities are associated with higher admission rates. Continuous observation is necessary to further understand paediatric COVID-19, guide therapy and evaluate the necessity for vaccination in children. What is Known: • Clinical manifestations of SARS-CoV-2 infection in children vary from asymptomatic to critical disease requiring intensive care unit admission. • Most studies are based on hospitalised children only; currently, there is limited data on non-hospitalised children. What is New: • The clinical spectrum and severity of COVID-19 is influenced by age: in children less than 2 years, fever, cough and rhinorrhoea are the most common symptoms and in adolescents, fever, cough and headache are more common. • Hospitalised children more often presented with fever and rash, while anosmia/dysgeusia is more prevalent in non-hospitalised children. • Children with pre-existing comorbidities are more frequently hospitalised but do not require ICU admission more often.
| Errataetall: | |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:181 |
|---|---|
| Enthalten in: |
European journal of pediatrics - 181(2022), 3 vom: 30. März, Seite 1245-1255 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Uka, Anita [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
COVID-19 |
|---|
| Anmerkungen: |
Date Completed 08.03.2022 Date Revised 28.07.2022 published: Print-Electronic ErratumIn: Eur J Pediatr. 2022 Jan 15;:. - PMID 35032201 Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00431-021-04276-9 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM333825640 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM333825640 | ||
| 003 | DE-627 | ||
| 005 | 20231225222437.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00431-021-04276-9 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1112.xml |
| 035 | |a (DE-627)NLM333825640 | ||
| 035 | |a (NLM)34845526 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Uka, Anita |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Factors associated with hospital and intensive care admission in paediatric SARS-CoV-2 infection |b a prospective nationwide observational cohort study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.03.2022 | ||
| 500 | |a Date Revised 28.07.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ErratumIn: Eur J Pediatr. 2022 Jan 15;:. - PMID 35032201 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a Coronavirus disease 2019 (COVID-19) is usually less severe in children compared to adults. This study describes detailed clinical characteristics, treatment and outcomes of children with COVID-19 in a non-hospitalised and hospitalised setting and quantifies factors associated with admission to hospital and intensive care unit in children with SARS-CoV-2 infection on a nationwide level. Data were collected through the Swiss Paediatric Surveillance Unit from children < 18 years with confirmed SARS-CoV-2 infection. All 33 paediatric hospitals in Switzerland reported non-hospitalised and hospitalised cases from March 1 to October 31, 2020 during both pandemic peaks. In total, 678 children were included. The median age was 12.2 years (IQR 5.0-14.6), 316 (46.6%) were female and 106 (15.6%) had comorbidities. Overall, 126 (18.6%) children were hospitalised of whom 16 (12.7%) required ICU admission. Comorbidities were the only factor associated with hospital admission in a multivariable regression analysis (odds ratio 3.23, 95%CI 1.89 to 5.50; p-value < 0.01). Children with preexisting comorbidities did not require ICU admission more often. Hospitalised children more often presented with fever (96 [76.2%] vs 209 [38.1%], p-value < 0.01) and rash (16 [12.8%] vs 6 [1.1%], p-value < 0.01). Anosmia/dysgeusia was more prevalent in non-hospitalised children (73 [13.3%] vs 3 [2.4%], p-value < 0.01). In hospitalised children, oxygen treatment was required in 34 (27.0%), inotropes in nine (7.3%) and mechanical ventilation in eight (6.3%) cases. Complications were reported in 28 (4.1%) children with cardiovascular complications being most frequent (12 [1.8%]). Three deaths were recorded.Conclusion: This study confirms that COVID-19 is mostly a mild disease in children. Fever, rash and comorbidities are associated with higher admission rates. Continuous observation is necessary to further understand paediatric COVID-19, guide therapy and evaluate the necessity for vaccination in children. What is Known: • Clinical manifestations of SARS-CoV-2 infection in children vary from asymptomatic to critical disease requiring intensive care unit admission. • Most studies are based on hospitalised children only; currently, there is limited data on non-hospitalised children. What is New: • The clinical spectrum and severity of COVID-19 is influenced by age: in children less than 2 years, fever, cough and rhinorrhoea are the most common symptoms and in adolescents, fever, cough and headache are more common. • Hospitalised children more often presented with fever and rash, while anosmia/dysgeusia is more prevalent in non-hospitalised children. • Children with pre-existing comorbidities are more frequently hospitalised but do not require ICU admission more often | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Child | |
| 650 | 4 | |a Clinical presentation | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Outcome | |
| 650 | 4 | |a Transmission | |
| 700 | 1 | |a Buettcher, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Bernhard-Stirnemann, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Fougère, Yves |e verfasserin |4 aut | |
| 700 | 1 | |a Moussaoui, Dehlia |e verfasserin |4 aut | |
| 700 | 1 | |a Kottanattu, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Wagner, Noémie |e verfasserin |4 aut | |
| 700 | 1 | |a Zimmermann, Petra |e verfasserin |4 aut | |
| 700 | 1 | |a Ritz, Nicole |e verfasserin |4 aut | |
| 700 | 0 | |a Swiss Paediatric Surveillance Unit (SPSU) |e verfasserin |4 aut | |
| 700 | 1 | |a Albisetti, M |e investigator |4 oth | |
| 700 | 1 | |a Bernet, V |e investigator |4 oth | |
| 700 | 1 | |a Betti, C |e investigator |4 oth | |
| 700 | 1 | |a Cachat, F |e investigator |4 oth | |
| 700 | 1 | |a Caplazi, P |e investigator |4 oth | |
| 700 | 1 | |a Decker, M-L |e investigator |4 oth | |
| 700 | 1 | |a Durrer, E |e investigator |4 oth | |
| 700 | 1 | |a Fluri, S |e investigator |4 oth | |
| 700 | 1 | |a Gebauer, M |e investigator |4 oth | |
| 700 | 1 | |a Gehri, M |e investigator |4 oth | |
| 700 | 1 | |a Giannoni, E |e investigator |4 oth | |
| 700 | 1 | |a Grupe, S |e investigator |4 oth | |
| 700 | 1 | |a Horn, M |e investigator |4 oth | |
| 700 | 1 | |a L'Huiller, A |e investigator |4 oth | |
| 700 | 1 | |a Karen, T |e investigator |4 oth | |
| 700 | 1 | |a Kellner, E |e investigator |4 oth | |
| 700 | 1 | |a Laube, G |e investigator |4 oth | |
| 700 | 1 | |a Laubscher, B |e investigator |4 oth | |
| 700 | 1 | |a Llor, J |e investigator |4 oth | |
| 700 | 1 | |a Luterbacher, F |e investigator |4 oth | |
| 700 | 1 | |a Madlon, H |e investigator |4 oth | |
| 700 | 1 | |a Malzacher, A |e investigator |4 oth | |
| 700 | 1 | |a Martins, M |e investigator |4 oth | |
| 700 | 1 | |a McDougall, J |e investigator |4 oth | |
| 700 | 1 | |a Merglen, A |e investigator |4 oth | |
| 700 | 1 | |a Minocchieri, S |e investigator |4 oth | |
| 700 | 1 | |a Muehlethaler, V |e investigator |4 oth | |
| 700 | 1 | |a Neuhaus, T |e investigator |4 oth | |
| 700 | 1 | |a Niederer, A |e investigator |4 oth | |
| 700 | 1 | |a Nikorelou, S |e investigator |4 oth | |
| 700 | 1 | |a Plebani, M |e investigator |4 oth | |
| 700 | 1 | |a Ratnasabapathy |e investigator |4 oth | |
| 700 | 1 | |a Relly, C |e investigator |4 oth | |
| 700 | 1 | |a Riedel, T |e investigator |4 oth | |
| 700 | 1 | |a Russo, M |e investigator |4 oth | |
| 700 | 1 | |a Schmid, H |e investigator |4 oth | |
| 700 | 1 | |a Staudacher, K |e investigator |4 oth | |
| 700 | 1 | |a Torres Escobar, M |e investigator |4 oth | |
| 700 | 1 | |a Wildhaber, J |e investigator |4 oth | |
| 700 | 1 | |a Wörner, A |e investigator |4 oth | |
| 700 | 1 | |a Zemmouri, A |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of pediatrics |d 1978 |g 181(2022), 3 vom: 30. März, Seite 1245-1255 |w (DE-627)NLM000029718 |x 0340-6199 |7 nnns |
| 773 | 1 | 8 | |g volume:181 |g year:2022 |g number:3 |g day:30 |g month:03 |g pages:1245-1255 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00431-021-04276-9 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 181 |j 2022 |e 3 |b 30 |c 03 |h 1245-1255 | ||