Comorbidities Associated with Hospitalization and Progression Among Adolescents with Symptomatic Coronavirus Disease 2019

• Published in: The Journal of pediatrics Vol. 245; pp. 102 - 110.e2
• Main Authors: Campbell, Jeffrey I., Dubois, Melanie M., Savage, Timothy J., Hood-Pishchany, M. Indriati, Sharma, Tanvi S., Petty, Carter R., Lamb, Gabriella S., Nakamura, Mari M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022
• Subjects: Adolescent; Asthma - epidemiology; Asthma - therapy; Child; Comorbidity; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; COVID-19 Testing; Diabetes Mellitus - epidemiology; Heart Diseases; Hospitalization; Humans; monoclonal antibodies; Obesity - epidemiology; Original; pediatrics; Renal Insufficiency, Chronic; Retrospective Studies; Risk Factors; SARS-CoV-2; COVID-19; EUA; SARS-CoV-2; hospitalization; SCD; pediatrics; adolescent; ICU; CKD; monoclonal antibodies; mAb
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2022.02.048

To identify subgroups likely to benefit from monoclonal antibody and antiviral therapy by evaluating the relationship between comorbidities and hospitalization among US adolescents with symptomatic coronavirus disease 2019 (COVID-19). We analyzed the relationship between presence of comorbidities and need for hospitalization within 28 days of COVID-19 diagnosis for adolescents aged 12-17 years listed in the Pediatric COVID-19 US registry, a multicenter retrospective cohort of US pediatric patients with COVID-19. Comorbidities assessed included obesity, chronic kidney disease (CKD), diabetes, immunosuppressive disease or treatment, sickle cell disease (SCD), heart disease, neurologic disease/neurodevelopmental disorders, and pulmonary disease (excluding patients with mild asthma). We used multivariable logistic regression to determine race/ethnicity-adjusted associations between comorbidities and hospitalization. A total of 1877 patients met our inclusion criteria, of whom 284 (15%) were hospitalized within 28 days of their COVID-19 diagnosis. In a race/ethnicity-adjusted model, the following comorbidities were independently associated with increased odds of hospitalization: SCD (aOR, 6.9; 95% CI, 3.0-15.9), immunocompromising condition (aOR, 6.4; 95% CI, 3.8-10.8), obesity (aOR, 3.2; 95% CI, 2.1-4.9), diabetes (aOR, 3.0; 95% CI, 1.4-6.2), neurologic disease (aOR, 2.8; 95% CI, 1.8-4.3), and pulmonary disease (excluding mild asthma) (aOR, 1.9; 95% CI, 1.2-3.1). Heart disease and CKD were not independently associated with hospitalization. SCD, immunocompromising conditions, obesity, diabetes, neurologic disease, and pulmonary disease (excluding mild asthma) were associated with hospitalization for symptomatic COVID-19. Adolescents with acute COVID-19 and these comorbidities should be prioritized for consideration of therapy to avert hospitalization.