COVID-19 in Pediatrics: Characteristics of Hospitalized Children in New Jersey

Abstract

OBJECTIVES: Understanding the risk factors, predictors, and clinical presentation of coronavirus disease 2019 (COVID-19) in pediatric patients with severe disease. METHODS: We conducted a retrospective chart review of pediatric patients admitted between March 1, 2020, and May 31, 2020, to a large health network in New Jersey with positive test results for severe acute respiratory syndrome coronavirus 2 on reverse transcriptase polymerase chain reaction, rapid testing, or serum immunoglobulin G testing; we included demographic characteristics, clinical features, and outcomes. RESULTS: A total of 81 patients ≤21 years old were admitted with positive test results for severe acute respiratory syndrome coronavirus 2 on reverse transcriptase polymerase chain reaction and/or serum immunoglobulin testing. Sixty-seven patients (82.7%) were admitted for management of acute COVID-19 infection, whereas 14 (17.3%) were admitted for management of multisystem inflammatory syndrome in children (MIS-C). Of the 81 hospitalized patients, 28 (34.6%) required intensive care. A majority of patients (42 [51.9%]) admitted for both acute COVID-19 infection and MIS-C were Hispanic. Underlying chronic health conditions were not present in most patients. Obesity (mean BMI of 41.1) was noted in the patients with MIS-C requiring ICU care, although not statistically significant. Absolute lymphopenia and elevated levels of inflammatory markers were statistically significant in the patients with MIS-C treated in the ICU. CONCLUSIONS: This study adds to the growing literature of potential risk factors for severe disease in pediatric patients due to COVID-19 infection and MIS-C. Patients of Hispanic ethnicity represented the majority of patients with both acute COVID-19 infection and MIS-C, despite only representing 10% to 20% of the population our hospitals serve. Infants and patients with chronic health conditions were not at increased risk for severe disease. Absolute lymphopenia and elevated levels of inflammatory markers were associated with more severe disease.

Characteristics of Hospitalized Children Positive for SARS-CoV-2: Experience of a Large Center

“…We found similar trends in socioeconomic status and ethnicity to previously published studies. 19,20 Specifically, even accounting for a high percentage of admissions of Hispanic, Spanish-speaking, and publicly insured children during the same time period, these populations were substantially overrepresented in our SARS-CoV-2 patients (86% vs 66.2% Hispanic, 34% vs 17.8% Spanish-speaking, and 88% vs 74.8% publicly insured or uninsured). Current available data reveal that vaccination rates among Hispanic/Latinx individuals lag substantially behind non-Hispanic white individuals, despite this population being heavily represented in essential industries.…”

Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis

“…We identified 9937 potentially relevant records from the literature databases and registers, and 1575 records from the additional searches. After screening the titles, abstracts and full texts, 56 studies (22 cohort studies, 9 case-control studies, and 25 case series) with a total of 79,104 patients were included [ [10] , [11] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] ] ( Fig. 1 ).…”

“…A total of 24 studies assessed factors associated with the risk of admission to ICU [ 10 , 11 , [24] , [25] , [26] , [27] , [28] , [29] , [31] , [32] , [33] , [34] , [35] , 41 , 43 , 44 , 54 , 57 , 58 , [61] , [62] , [63] , [64] , 70 ]. The pooled results from three studies showed that age less than 1 month was associated with an increased risk of admission to ICU ( OR =2.29, 95% CI 1.48 to 3.56, moderate-quality evidence).…”

Parent and Adolescent Perspectives on the Impact of COVID on the Care of Seriously Ill Children

“…Children with serious illnesses represent a small percentage of the pediatric population yet they may be particularly vulnerable to adverse outcomes due to underlying conditions and treatments such as immunosuppressive therapy. 17 , 18 , 19 Routine challenges parent caregivers of seriously ill children face may also be compounded by additional considerations such as complex care coordination, 20 high reliance on hospital-based services and medical technology, 17 worries related to the child's enhanced vulnerabilities 22 and maintaining routine care such as disease directed therapies, school-based therapies, and home nursing for activities of daily living support. 14 , 15 , 23 In addition, certain hospital-based or rehabilitation services cannot feasibly occur at home or through telehealth.…”