Preexisting chronic conditions, including asthma and obesity, are associated with COVID-19 disease severity in children, according to a study published online Sept. 15 in the Journal of Hospital Medicine.
James W. Antoon, M.D., Ph.D., from Vanderbilt University in Nashville, Tennessee, and colleagues used data from 45 U.S. children’s hospitals (April to September 2020) to assess clinical factors associated with COVID-19 disease severity in children and adolescents.
The researchers identified 19,976 COVID-19 encounters; of these, 79.7 percent of pediatric patients were discharged from the emergency department and 20.3 percent were hospitalized. Of those hospitalized, 79.3 percent had moderate disease, 11.3 percent had severe disease, and 9.4 percent had very severe disease. Private payer insurance (adjusted odds ratio [aOR], 1.16), obesity/type 2 diabetes mellitus (aOR, 10.4), asthma (aOR, 1.4), cardiovascular disease (aOR, 5.0), immunocompromised condition (aOR, 5.9), pulmonary disease (aOR, 5.3), and neurologic disease (aOR, 3.2) were factors associated with hospitalization versus emergency department discharge. Black or other non-White race, age older than 4 years, and obesity/type 2 diabetes mellitus and cardiovascular, neuromuscular, and pulmonary conditions were factors associated with greater disease severity among hospitalized children and adolescents.
“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 said in a statement.
One author disclosed financial ties to the pharmaceutical industry.