Published May 28, 2021 | Version v1
Journal article Open

Thirty-Day Outcomes of Children and Adolescents With COVID-19: An International Experience.

Authors/Creators

  • 1. Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
  • 2. Bayer Pharmaceuticals, Sant Joan Despi, Spain.
  • 3. Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain.
  • 4. Real-World Evidence, Trial Form Support, Barcelona, Spain.
  • 5. Janssen Research & Development, Titusville, New Jersey.
  • 6. School of Medical Sciences, University of Manchester, Manchester, United Kingdom
  • 7. Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
  • 8. Medication Safety Research, King Saud University, Riyadh, Saudi Arabia
  • 9. Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
  • 10. Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts
  • 11. Department of Biomedical Informatics, School of Medicine, Ajou University, Suwon, South Korea
  • 12. Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
  • 13. Department of Veterans Affairs, Salt Lake City, Utah
  • 14. Department of Biomedical Informatics, Columbia University, New York, New York
  • 15. Janssen Research & Development, Titusville, New Jersey
  • 16. Regeneron Pharmaceuticals, Tarrytown, New York
  • 17. DHC Technologies, Co, Ltd, Beijing, China
  • 18. Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, Maryland
  • 19. Bayer AG, Wuppertal, Germany.
  • 20. Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
  • 21. School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • 22. Department of Medicine, School of Medicine, Stanford University, Stanford, California.
  • 23. Data Science to Patient Value Program, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
  • 24. Department of Medicine, School of Medicine, Stanford University, Stanford, California
  • 25. Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands

Description

Objectives: To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children and adolescents diagnosed or hospitalized with coronavirus disease 2019 (COVID-19) and to compare them in secondary analyses with patients diagnosed with previous seasonal influenza in 2017-2018.

Methods: International network cohort using real-world data from European primary care records (France, Germany, and Spain), South Korean claims and US claims, and hospital databases. We included children and adolescents diagnosed and/or hospitalized with COVID-19 at age <18 between January and June 2020. We described baseline demographics, comorbidities, symptoms, 30-day in-hospital treatments, and outcomes including hospitalization, pneumonia, acute respiratory distress syndrome, multisystem inflammatory syndrome in children, and death.

Results: A total of 242 158 children and adolescents diagnosed and 9769 hospitalized with COVID-19 and 2 084 180 diagnosed with influenza were studied. Comorbidities including neurodevelopmental disorders, heart disease, and cancer were more common among those hospitalized with versus diagnosed with COVID-19. Dyspnea, bronchiolitis, anosmia, and gastrointestinal symptoms were more common in COVID-19 than influenza. In-hospital prevalent treatments for COVID-19 included repurposed medications (<10%) and adjunctive therapies: systemic corticosteroids (6.8%-7.6%), famotidine (9.0%-28.1%), and antithrombotics such as aspirin (2.0%-21.4%), heparin (2.2%-18.1%), and enoxaparin (2.8%-14.8%). Hospitalization was observed in 0.3% to 1.3% of the cohort diagnosed with COVID-19, with undetectable (n < 5 per database) 30-day fatality. Thirty-day outcomes including pneumonia and hypoxemia were more frequent in COVID-19 than influenza.

Conclusions: Despite negligible fatality, complications including hospitalization, hypoxemia, and pneumonia were more frequent in children and adolescents with COVID-19 than with influenza. Dyspnea, anosmia, and gastrointestinal symptoms could help differentiate diagnoses. A wide range of medications was used for the inpatient management of pediatric COVID-19.

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2021_Pediatrics_Thirty days outcomes of children and adolescence with COVID-19.pdf

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Additional details

Funding

European Commission
EHDEN - European Health Data and Evidence Network 806968