Hospitalization Rates and Characteristics of Children Aged &lt;18 Years Hospitalized with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 1–July 25, 2020

Kim, Lindsay; Whitaker, Michael; O’Halloran, Alissa; Kambhampati, Anita; Chai, Shua J.; Reingold, Arthur; Armistead, Isaac; Kawasaki, Breanna; Meek, James; Yousey‐Hindes, Kimberly; Anderson, Evan J.; Openo, Kyle P.; Weigel, Andy; Ryan, Patricia; Monroe, Maya; Fox, Kimberly; Kim, Sue; Lynfield, Ruth; Bye, Erica; Davis, Sarah Shrum; Smelser, Chad; Barney, Grant; Spina, Nancy; Bennett, Nancy M.; Felsen, Christina B.; Billing, Laurie M; Shiltz, Jessica; Sutton, Melissa; West, Nicole; Talbot, H. Keipp; Schaffner, William; Risk, Ilene; Price, Andrea; Brammer, Lynnette; Fry, Alicia M.; Hall, Aron J.; Langley, Gayle; Garg, Shikha; Coates, Ashley; Kirley, Pam Daily; Libby, Tanya; Roland, Jeremy; Alden, Nisha; Herlihy, Rachel; McLafferty, Sarah; Clogher, Paula; Kayalioglu, Hazal; Maslar, Amber; Misiorski, Adam; Niccolai, Linda M.; Olson, Danyel M; Parisi, Christina; Fawcett, Emily; Gretzinger, Siyeh; Lengacher, Katelyn; Williams, Jeremiah; Blythe, David; Brooks, Alicia; Park, Rachel; Wilson, Michelle; Como‐Sabetti, Kathryn; Danila, Richard; Cline, Cory; Angeles, Kathy; Eisenberg, Nancy; Flores, Kristina; Habrun, Caroline A.; Hancock, Emily B.; Khanlian, Sarah A.; Novi, Meaghan; Phipps, Erin C; Salazar-Sanchez, Yadira; Dufort, Elizabeth; Muse, Alison; Bushey, Sophrena; Gaitán, Maria; Kurtz, RaeAnne; Owusu-Dommey, Ama; Snyder, Lindsey; Michaelis, Katherine A.; Seeley, Kylie; Markus, Tiffanie; Chatelain, Ryan; George, Andrea; Hill, Mary; McCullough, Laine; Spencer, Melanie; Swain, Ashley; McCaffrey, Keegan; Holstein, Rachel; Meador, Seth; Wortham, Jonathan M.

doi:10.15585/mmwr.mm6932e3

Cited by 496 publications

(498 citation statements)

References 9 publications

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“…The vast majority of pediatric SARS-CoV-2 infections are asymptomatic or cause only mild symptoms. In the United States, pediatric hospitalization rates are low (8.0/100,000 persons) compared with those for adults (164.5/100,000 persons) (11). Although one-third of hospitalized children require intensive care (similar to adults), severe COVID-19 and death rarely occur in children and are usually limited to those with underlying health conditions (including obesity) or infants (12).…”

Section: A Sars-cov-2-associated Hyperinflammatory Syndrome In Childrenmentioning

confidence: 99%

Inflammatory syndromes associated with SARS-CoV-2 infection: dysregulation of the immune response across the age spectrum

Clark

Vogel

Atmar

et al. 2020

Journal of Clinical Investigation

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Section: A Sars-cov-2-associated Hyperinflammatory Syndrome In Childrenmentioning

confidence: 99%

Inflammatory syndromes associated with SARS-CoV-2 infection: dysregulation of the immune response across the age spectrum

Clark

Vogel

Atmar

et al. 2020

Journal of Clinical Investigation

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“…As infections with SARS-CoV-2 and its associated illness, COVID-19, have surged across the world, multiple studies have identified higher rates of infection, hospitalization, and mortality among minority populations. [1][2][3][4][5][6][7][8][9][10][11][12] Disparities in infection rates exist even among healthcare workers 13 and children, 14,15 with disparities in mortality rates greatest among young individuals 16 and growing as the pandemic spreads. 17 To date, the relative contributions of pathophysiologic and socioeconomic factors contributing to these disparities remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Geospatial Analysis of Individual and Community-Level Socioeconomic Factors Impacting SARS-CoV-2 Prevalence and Outcomes

Cromer

Lakhani

Wexler

et al. 2020

Preprint

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Background: The SARS-CoV-2 pandemic has disproportionately affected racial and ethnic minority communities across the United States. We sought to disentangle individual and census tract-level sociodemographic and economic factors associated with these disparities. Methods and Findings: All adults tested for SARS-CoV-2 between February 1 and June 21, 2020 were geocoded to a census tract based on their address; hospital employees and individuals with invalid addresses were excluded. Individual (age, sex, race/ethnicity, preferred language, insurance) and census tract-level (demographics, insurance, income, education, employment, occupation, household crowding and occupancy, built home environment, and transportation) variables were analyzed using linear mixed models predicting infection, hospitalization, and death from SARS-CoV-2. Among 57,865 individuals, per capita testing rates, individual (older age, male sex, non-White race, non-English preferred language, and non-private insurance), and census tract-level (increased population density, higher household occupancy, and lower education) measures were associated with likelihood of infection. Among those infected, individual age, sex, race, language, and insurance, and census tract-level measures of lower education, more multi-family homes, and extreme household crowding were associated with increased likelihood of hospitalization, while higher per capita testing rates were associated with decreased likelihood. Only individual-level variables (older age, male sex, Medicare insurance) were associated with increased mortality among those hospitalized. Conclusions: This study of the first wave of the SARS-CoV-2 pandemic in a major U.S. city presents the cascade of outcomes following SARS-CoV-2 infection within a large, multi-ethnic cohort. SARS-CoV-2 infection and hospitalization rates, but not death rates among those hospitalized, are related to census tract-level socioeconomic characteristics including lower educational attainment and higher household crowding and occupancy, but not neighborhood measures of race, independent of individual factors.

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“…39 Data indicate that children made up only 0.5%-3.7% of all hospitalisations and between 0.2%-8% of paediatric cases were hospitalised. 40 Regarding those hospitalised, recent numbers suggest up to 33% of hospitalised children require care in an Intensive Care Unit (ICU), 40 a rate similar to adult ICU admissions. Investigation into the children who are requiring ICU-level care revealed that 83% had underlying medical conditions.…”

Section: Safer Infection For Healthy Childrenmentioning

confidence: 99%

“…While an estimated 2% ICU admission rate of known paediatric infections with SARS-CoV-2 may seem relatively insignificant, incidence of anaphylaxis after vaccine injection is less than 1/10 000 of the rate of ICU admission for children with SARS-CoV-2, for example. 40 In addition, our understanding of the COVID-related risks to children is still evolving. Beginning in May of 2020, there was an increasing number of cases of a disorder connected to SARS-CoV-2 infection, Multisystem Inflammatory Syndrome in Children (MIS-C).…”

Section: Safer Infection For Healthy Childrenmentioning

confidence: 99%

“…This autoimmune-like illness causes capillary leak, end-organ dysfunction and potential long-term cardiac, endovascular and pulmonary damage and even death. 40 So far in the USA, there have been almost 1000 documented cases of MIS-C with 19 deaths. 42 Research on genetic susceptibility to COVID-19 might reveal a mutation that is associated with an increased risk of developing MIS-C. 43 In that case, children can be genotyped prior to admission to a safer infection site and only those at low risk of developing MIS-C would be eligible.…”

Section: Safer Infection For Healthy Childrenmentioning

confidence: 99%

See 1 more Smart Citation

SARS-CoV-2 safer infection sites: moral entitlement, pragmatic harm reduction strategy or ethical outrage?

Hunt¹,

Clark²,

Geller

et al. 2020

J Med Ethics

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The pandemic of SARS-CoV-2 has led to unprecedented changes to society, causing unique problems that call for extraordinary solutions. We consider one such extraordinary proposal: ‘safer infection sites’ that would offer individuals the opportunity to be intentionally infected with SARS-CoV-2, isolate, and receive medical care until they are no longer infectious. Safer infection could have value for various groups of workers and students. Health professionals place themselves at risk of infection daily and extend this risk to their family members and community. Similarly, other essential workers who face workplace exposure must continue their work, even if have high-risk household members and live in fear of infecting. When schools are kept closed because of the fear that they will be sites of significant transmission, children and their families are harmed in multiple ways and college students who are living on campus, whether or not they are attending classes in person, are contributing to high rates of transmission and experiencing high rates of exposure. We consider whether offering safer infection sites to these groups could be ethically defensible and identify the empirical unknowns that would need to resolve before reaching definitive conclusions. This article is not an endorsement of intentional infection with the coronavirus, but rather is meant to spark conversation on the ethics of out-of-the-box proposals. Perhaps most meaningfully, our paper explores the value of control and peace of mind for those among us most impacted by the pandemic: those essential workers risking the most to keep us safe.

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Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 1–July 25, 2020

Cited by 496 publications

References 9 publications

Inflammatory syndromes associated with SARS-CoV-2 infection: dysregulation of the immune response across the age spectrum

Inflammatory syndromes associated with SARS-CoV-2 infection: dysregulation of the immune response across the age spectrum

Geospatial Analysis of Individual and Community-Level Socioeconomic Factors Impacting SARS-CoV-2 Prevalence and Outcomes

SARS-CoV-2 safer infection sites: moral entitlement, pragmatic harm reduction strategy or ethical outrage?

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