Risk factors for SARS-CoV-2 infection and hospitalisation in children and adolescents in Norway: a nationwide population-based study

• Published in: BMJ open Vol. 12; no. 3; p. e056549
• Main Authors: Størdal, Ketil, Ruiz, Paz Lopez-Doriga, Greve-Isdahl, Margrethe, Surén, Pål, Knudsen, Per Kristian, Gulseth, Hanne Løvdal, Tapia, German
• Format: Journal Article
• Language: English; Norwegian
• Published: England British Medical Journal Publishing Group 11.03.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Adolescent; Age groups; Asthma; Child; Chronic illnesses; Classification; Codes; Cohort Studies; Comorbidity; Coronaviruses; country of origin; COVID-19; COVID-19 - epidemiology; Disease transmission; Emergency preparedness; Families & family life; Family income; hospitalisation; Hospitalization; Hospitals; Households; Humans; Infections; Paediatrics; Pandemics; Population; Population-based studies; Primary care; risk factor; Risk Factors; SARS-CoV-2; Serology; Severe acute respiratory syndrome coronavirus 2; Socioeconomic factors; socioeconomy; Teenagers; Norway; COVID-19; SARS-CoV-2; comorbidity; country of origin; socioeconomy; hospitalisation; risk factor
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-056549

ObjectiveTo determine risk factors for SARS-CoV-2 infection and hospitalisation among children and adolescents.DesignNationwide, population-based cohort study.SettingNorway from 1 March 2020 to 30 November 2021.ParticipantsAll Norwegian residents<18 years of age.Main outcome measuresPopulation-based healthcare and population registries were used to study risk factors for SARS-CoV-2 infection, including socioeconomic factors, country of origin and pre-existing chronic comorbidities. All residents were followed until age 18 years, emigration, death or end of follow-up. HRs estimated by Cox regression models were adjusted for testing frequency. Further, risk factors for admission to the hospital among the infected were investigated.ResultsOf 1 219 184 residents, 82 734 (6.7%) tested positive by PCR or lateral flow tests, of whom 241 (0.29%) were admitted to a hospital. Low family income (adjusted HR (aHR) 1.26, 95% CI 1.23 to 1.30), crowded housing (1.27, 1.24 to 1.30), household size, age, non-Nordic country of origin (1.63, 1.60 to 1.66) and area of living were independent risk factors for infection. Chronic comorbidity was associated with a slightly lower risk of infection (aHR 0.90, 95% CI 0.88 to 0.93). Chronic comorbidity was associated with hospitalisation (aHR 3.46, 95% CI 2.50 to 4.80), in addition to age, whereas socioeconomic status and country of origin did not predict hospitalisation among those infected.ConclusionsSocioeconomic factors, country of origin and area of living were associated with the risk of SARS-CoV-2 infection. However, these factors did not predict hospitalisation among those infected. Chronic comorbidity was associated with higher risk of admission but slightly lower overall risk of acquiring SARS-CoV-2.