Older Children with Comorbidities Most Likely to Experience Severe COVID disease

To support disease mitigation strategies for children who are at high risk of developing severe COVID disease, a group of physicians at Monroe Carell Jr. Children’s Hospital at Vanderbilt, located in Tennessee, studied data from 45 children’s hospitals around the USA.

The retrospective cohort study noted that approximately 20% of children admitted to hospitals with COVID developed severe disease and required Intensive care unit care during April and September 2020.

Older children and adolescent patients had a lower risk of hospitalization. However, when hospitalized, they had greater illness severity.

Those with selected comorbidities (cardiovascular, obesity, type 2 DM, pulmonary and neurologic or neuromuscular disease had both increased odds of hospitalization and in-hospital illness severity. 

The study, “Factors Associated with COVID-19 Disease Severity in U.S. Children,” published in the Journal of Hospital Medicine on September 15, 2021, determined the factors associated with severe disease and poor health outcomes among 2,000 children presenting to the hospital with COVID.

These included older age and chronic comorbidities such as obesity, diabetes, and neurologic conditions, among others.

“This is one of the largest multicenter studies of children with COVID-19 in the United States,” stated James Antoon, M.D., Ph.D., FAAP, assistant professor of Pediatrics at Children’s Hospital and lead author of the study, in a press release.

“And given the recent, concerning increases in COVID cases nationwide and the fact that the vast majority of children remain unvaccinated and susceptible, these findings should be taken into account when considering preventive strategies in schools and planning vaccinations when available for children less than 12 years of age,” Antoon added.

“These factors help identify vulnerable children who are most likely to require hospitalization or develop severe COVID-19 disease,” said Antoon. “Our findings also highlight children who should be prioritized for COVID-19 vaccines when approved by the FDA.”

“Across the country, there is a raging debate on how best to protect children and schools from COVID-19,” said Antoon. “Some children are at increased risk for more severe disease, and many of them are not yet eligible for a vaccination against COVID.

No industry conflicts of interest were disclosed by the researchers.