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

• Published in: Pediatrics (Evanston) Vol. 148; no. 3; p. 1
• 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: Evanston American Academy of Pediatrics 01.09.2021
• Subjects: Adolescent; Adolescents; Age Distribution; Anosmia; Aspirin; Bronchopneumonia; Child; Children; Cohort Studies; Comorbidity; complications; Coronary artery disease; Coronaviruses; Corticosteroids; COVID-19; Demography; diagnosis; Differential; drug therapy; Dyspnea; epidemiology; Factual; Famotidine; Fatalities; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; France; Germany; Heart diseases; Heparin; Hospitalization; Human; Humans; Hypoxemia; Infant; Infectious Medicine; Infektionsmedicin; Inflammation; Influenza; Male; Medical treatment; Multisystem inflammatory syndrome in children; Neurodevelopmental disorders; Newborn; Olfaction disorders; Pediatrics; Pediatrik; Pneumonia; Preschool; Public Health, Global Health, Social Medicine and Epidemiology; Republic of Korea; Respiration; Respiratory distress syndrome; Spain; statistics & numerical data; Symptom Assessment; Teenagers; Time Factors; Treatment Outcome; United States; United States; South Korea; Europe
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2020-042929

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.