Hospital Admission in Children and Adolescents With COVID-19

Armann, Jakob; Diffloth, Natalie; Simon, Arne; Doenhardt, Maren; Hufnagel, Markus; Trotter, Andreas; Schneider, Dominik; Hübner, Johannes; Berner, Reinhard

doi:10.3238/arztebl.2020.0373

Cited by 47 publications

(47 citation statements)

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“…While fever as the most common symptom among adults [21] was present in seven patients in our cohort, the second most frequent symptoms dyspnoea and cough were only present in four patients. This is in line with other reports that found respiratory symptoms less frequently in paediatric patients [2,3,5], Four patients required respiratory support, which is lower than around 65% in need of oxygen treatment reported among adults [21], but higher compared to other reports on paediatric COVID cases [2,3]. This might point at an elevated risk of severe disease among our patient population although these ndings are inconclusive due to the small number of patients.…”

Section: Characteristics Of Patients Admitted With Covid-19supporting

confidence: 91%

“…Among the nine patients admitted to our hospital with COVID-19, ve had serious underlying health conditions, among them two patients in need of PICU admission. This is a high rate compared to literature reporting of only a fourth of the children admitted for COVID-19 having underlying health conditions [2], which might point at an increased risk in our patient population.…”

Section: Characteristics Of Patients Admitted With Covid-19contrasting

confidence: 49%

“…As presentation with atypical symptoms has frequently occurred in our cohort as well as other cohorts of paediatric COVID-19 patients [2,3,5], broadening of test criteria is justi ed. Although we did not observe asymptomatic SARS-CoV-2 infection in our cohort, routine testing of asymptomatic children at risk is essential, since transmission of COVID-19 can occur prior to symptom onset or patients may show very little or atypical symptoms [31].…”

Section: Testing Proceduresmentioning

confidence: 89%

“…This outbreak challenges healthcare systems worldwide [1]. Children generally develop milder disease than adults; the majority of infections are asymptomatic or manifest as upper respiratory tract infection or mild pneumonia [2][3][4]. Nevertheless, severe and fatal cases have been reported in children [5].…”

Section: Introductionmentioning

confidence: 99%

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Infection Control and Management of COVID-19: Challenges for Paediatric Tertiary Care Hospitals

Remppis¹,

Ganzenmueller²,

Vasconcelos³

et al. 2020

Preprint

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PURPOSE: To describe infection control measures and patient management at a tertiary children’s hospital in southern Germany during the COVID-19 pandemic.METHODS: Prospective, observational study of infection control measures, patient management, clinical and virologic data of paediatric patients treated at our hospital during the COVID-19 pandemic from February to May 2020. Infection control measures were documented beginning with preparation for the pandemic. All paediatric patients with suspected SARS-CoV-2 infection were prospectively included in the study.RESULTS: With local triage, restraint of patient admission and testing strategies implemented, healthcare capacity remained adequate and no healthcare-associated infections occurred. Workload in the paediatric emergency department significantly decreased following the lockdown of schools and kindergartens. 7 of 174 (4%) children with and 2 of 208 (1%) children without typical symptoms, respectively, were diagnosed with COVID-19 by PCR. Six out of nine inpatients treated for COVID-19 had underlying comorbidities, two were admitted to the intensive care unit. One patient died shortly after discharge.CONCLUSIONS: While COVID-19 generally causes mild disease in children, severe illness and fatal cases may occur, particularly among children with underlying diseases. Tertiary children’s hospitals may face challenges with treating potential high-risk patients during the pandemic. Thus, timely establishment of effective testing and triage strategies is crucial.

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Section: Characteristics Of Patients Admitted With Covid-19supporting

confidence: 91%

Section: Characteristics Of Patients Admitted With Covid-19contrasting

confidence: 49%

Section: Testing Proceduresmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Infection Control and Management of COVID-19: Challenges for Paediatric Tertiary Care Hospitals

Remppis¹,

Ganzenmueller²,

Vasconcelos³

et al. 2020

Preprint

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show abstract

“…Das [4,10,31]. Zudem werden SARS-CoV-2-Infektionen bei Kindern und Jugendlichen mit rheumatischen Grunderkrankungen anhand eines Zusatzmoduls der Kerndokumentation rheumakranker Kinder und Jugendlicher oder im BiKeR-Register erfasst.…”

Section: Hintergrundunclassified

COVID-19: Behandlungsstrategien der deutschsprachigen Kinderrheumatologen

et al. 2020

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Zusammenfassung Hintergrund Zuverlässige Daten zu Verlauf und Therapie von COVID-19 („corona virus disease 2019“) bei Kindern mit rheumatischen Erkrankungen unter Immunsuppression fehlen. Ziel der Arbeit Abbildung individueller Strategien der Mitglieder der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR) im Umgang mit COVID-19. Methodik Mittels Online-Umfrage wurden im Mai 2020 das Meinungsbild der GKJR-Mitglieder zum Umgang mit DMARDs („disease-modifying anti-rheumatic drugs“) bei COVID-19-Erkrankung sowie die Bereitschaft zum Einsatz spezieller Therapieansätze bei Patienten mit unterschiedlicher Schwere von COVID-19 erhoben. Ergebnisse Es nahmen 71 Kollegen (27,3 % aller befragten ärztlichen Mitglieder) an der Umfrage teil; davon hatten 28,2 % bereits Patienten mit COVID-19 betreut. Über 95 % der Teilnehmer lehnten eine präventive Anpassung der antirheumatischen Therapie im Rahmen der SARS-CoV-2-Pandemie ab. Bei ambulanten Patienten unter Immunsuppression mit nachgewiesener COVID-19-Erkrankung würden mehr als 50 % der Teilnehmer folgende Therapien aussetzen: intravenöse hoch dosierte Steroide, Cyclophosphamid, Anti-CD20-Antikörper, sowie eine BAFF-, CTLA-4-, TNF-α-Blockade. Hingegen würden nichtsteroidale Antiphlogistika, Hydroxychloroquin (HCQ), orale Steroide, Mycophenolat, IL-1-Blockade sowie Immunglobuline (Ig) von >70 % der Kollegen weiter fortgeführt. Bei stationären Patienten mit COVID-19 würden insgesamt 74,6 % der Kollegen eine COVID-19-gerichtete Therapie erwägen. Bei stabilem Verlauf unter O2-Therapie (Stufe I) würden am häufigsten HCQ (18,3 %), Azithromycin (16,9 %) und Ig (9,9 %) in Betracht gezogen. Bei drohendem (Stufe II) bzw. manifestem Zytokinsturm (Stufe III) würden am häufigsten Anakinra (40,8 % bei Stufe II bzw. 46,5 % bei Stufe III), Tocilizumab (26,8 % bzw. 40,8 %), Steroide (25,4 % bzw. 33,8 %) und Remdesivir (29,6 % bzw. 38,0 %) eingesetzt. Von vielen Kollegen wurde betont, dass die Therapiestrategie individuell und der klinischen Situation entsprechend angepasst werden soll. Diskussion Die Ergebnisse der Online-Umfrage sind vor dem Hintergrund einer aktuell in Deutschland niedrigen Prävalenz von COVID-19 zu sehen und spiegeln somit theoretische Überlegungen der Befragten wider. Da Kinder derzeit nicht im Fokus von prospektiven COVID-19-Studien stehen, scheint der kontinuierliche und kritische kollegiale Fachaustausch bei Therapieentscheidungen umso wichtiger zu sein.

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Prevalence of SARS-CoV-2 Infection in Children and Their Parents in Southwest Germany

et al. 2021

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daycare closures were enforced as measures to confine the novel coronavirus disease 2019 (COVID-19) pandemic, based on the assumption that young children may play a key role in severe acute respiratory coronavirus 2 (SARS-CoV-2) spread. Given the grave consequences of contact restrictions for children, a better understanding of their contribution to the COVID-19 pandemic is of great importance. OBJECTIVE To describe the rate of SARS-CoV-2 infections and the seroprevalence of SARS-CoV-2 antibodies in children aged 1 to 10 years, compared with a corresponding parent of each child, in a population-based sample. DESIGN, SETTING, AND PARTICIPANTS This large-scale, multicenter, cross-sectional investigation (the COVID-19 BaWü study) enrolled children aged 1 to 10 years and a corresponding parent between April 22 and May 15, 2020, in southwest Germany. EXPOSURES Potential exposure to SARS-CoV-2. MAIN OUTCOMES AND MEASURES The main outcomes were infection and seroprevalence of SARS-CoV-2. Participants were tested for SARS-CoV-2 RNA from nasopharyngeal swabs by reverse transcription-polymerase chain reaction and SARS-CoV-2 specific IgG antibodies in serum by enzyme-linked immunosorbent assays and immunofluorescence tests. Discordant results were clarified by electrochemiluminescence immunoassays, a second enzyme-linked immunosorbent assay, or an in-house Luminex-based assay. RESULTS This study included 4964 participants: 2482 children (median age, 6 [range, 1-10] years; 1265 boys [51.0%]) and 2482 parents (median age, 40 [range, 23-66] years; 615 men [24.8%]). Two participants (0.04%) tested positive for SARS-CoV-2 RNA. The estimated SARS-CoV-2 seroprevalence was low in parents (1.8% [95% CI, 1.2-2.4%]) and 3-fold lower in children (0.6% [95% CI, 0.3-1.0%]). Among 56 families with at least 1 child or parent with seropositivity, the combination of a parent with seropositivity and a corresponding child with seronegativity was 4.3 (95% CI, 1.19-15.52) times higher than the combination of a parent who was seronegative and a corresponding child with seropositivity. We observed virus-neutralizing activity for 66 of 70 IgG-positive serum samples (94.3%). CONCLUSIONS AND RELEVANCE In this cross-sectional study, the spread of SARS-CoV-2 infection during a period of lockdown in southwest Germany was particularly low in children aged 1 to 10 years. Accordingly, it is unlikely that children have boosted the pandemic. This SARS-CoV-2 prevalence study, which appears to be the largest focusing on children, is instructive for how ad hoc mass testing provides the basis for rational political decision-making in a pandemic.

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Hospital Admission in Children and Adolescents With COVID-19

Cited by 47 publications

References 5 publications

Infection Control and Management of COVID-19: Challenges for Paediatric Tertiary Care Hospitals

Infection Control and Management of COVID-19: Challenges for Paediatric Tertiary Care Hospitals

COVID-19: Behandlungsstrategien der deutschsprachigen Kinderrheumatologen

Prevalence of SARS-CoV-2 Infection in Children and Their Parents in Southwest Germany

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