About 12% of U.S. children with COVID-19 were hospitalized in 2020, and nearly a third of those had severe disease that required mechanical ventilation or admission to an intensive care unit, according to a new study published in JAMA Network Open on April 9.
That means about 1 in 9 children with COVID-19 needed hospitalization, and about 1 in 28 had severe COVID-19.
“Although most children with COVID-19 experience mild illness, some children develop serious illness that leads to hospitalization, use of invasive mechanical ventilation, and death,” the researchers wrote.
The research team analyzed discharge data from 869 medical facilities in the Premier Healthcare Database Special COVID-19 Release. They looked for COVID-19 patients ages 18 and under who had an in-patient or emergency department visit between March and October 2020.
More than 20,700 children with COVID-19 had an inpatient or emergency department visit, and 2,430 were hospitalized with COVID-19. Among those, 756 children had severe COVID-19 and were admitted to an intensive care unit or needed mechanical ventilation.
About 53% of the COVID-19 patients were girls, and about 54% were between ages 12 and 18. In addition, about 29% had at least one chronic condition.
As with COVID-19 studies in adults, Hispanic, Latino and Black patients were overrepresented. About 39% of the children were Hispanic or Latino, and 24% were Black. However, the researchers did not find an association between severe COVID-19 and race or ethnicity.
The likelihood of severe COVID-19 increased if the patient had at least one chronic condition, was male, or was between ages 2 and 11.
“Understanding factors associated with severe COVID-19 disease among children could help inform prevention and control strategies,” they added. “Reducing infection risk through community mitigation strategies is critical for protecting children from COVID-19 and preventing poor outcomes.”
As of April 8, more than 3.54 million U.S. children had tested positive for COVID-19, according to the latest report from the American Academy of Pediatrics and Children’s Hospital Association. Cases among children are increasing slightly, with about 73,000 new cases reported during the first week of April.
Children represent about 13.5% of the COVID-19 cases in the country, according to the report. Among the 24 states that provide data, children represented 1%-3% of all COVID-19 hospitalizations, and less than 2% of all child COVID-19 cases resulted in hospitalization.
“At this time, it appears that severe illness due to COVID-19 is rare among children,” the two groups wrote.
“However, there is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects,” they added.
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