Baseline characteristics, management, and outcomes of 55,270 children and adolescents diagnosed with COVID-19 and 1,952,693 with influenza in France, Germany, Spain, South Korea and the United States: an international network cohort study

• Published in: medRxiv : the preprint server for health sciences
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: United States 30.10.2020
• DOI: 10.1101/2020.10.29.20222083

To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children/adolescents diagnosed or hospitalized with COVID-19. Secondly, to describe health outcomes amongst children/adolescents diagnosed with previous seasonal influenza. International network cohort. Real-world data from European primary care records (France/Germany/Spain), South Korean claims and US claims and hospital databases. Diagnosed and/or hospitalized children/adolescents with COVID-19 at age <18 between January and June 2020; diagnosed with influenza in 2017-2018. Baseline demographics and comorbidities, symptoms, 30-day in-hospital treatments and outcomes including hospitalization, pneumonia, acute respiratory distress syndrome (ARDS), multi-system inflammatory syndrome (MIS-C), and death. A total of 55,270 children/adolescents diagnosed and 3,693 hospitalized with COVID-19 and 1,952,693 diagnosed with influenza were studied. Comorbidities including neurodevelopmental disorders, heart disease, and cancer were all more common among those hospitalized vs diagnosed with COVID-19. The most common COVID-19 symptom was fever. Dyspnea, bronchiolitis, anosmia and gastrointestinal symptoms were more common in COVID-19 than influenza. In-hospital treatments for COVID-19 included repurposed medications (<10%), and adjunctive therapies: systemic corticosteroids (6.8% to 37.6%), famotidine (9.0% to 28.1%), and antithrombotics such as aspirin (2.0% to 21.4%), heparin (2.2% to 18.1%), and enoxaparin (2.8% to 14.8%). Hospitalization was observed in 0.3% to 1.3% of the COVID-19 diagnosed cohort, with undetectable (N<5 per database) 30-day fatality. Thirty-day outcomes including pneumonia, ARDS, and MIS-C were more frequent in COVID-19 than influenza. Despite negligible fatality, complications including pneumonia, ARDS and MIS-C were more frequent in children/adolescents with COVID-19 than with influenza. Dyspnea, anosmia and gastrointestinal symptoms could help differential diagnosis. A wide range of medications were used for the inpatient management of pediatric COVID-19.