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Underlying Medical Conditions Associated With Severe COVID-19 Illness Among Children.
Kompaniyets, Lyudmyla; Agathis, Nickolas T; Nelson, Jennifer M; Preston, Leigh Ellyn; Ko, Jean Y; Belay, Brook; Pennington, Audrey F; Danielson, Melissa L; DeSisto, Carla L; Chevinsky, Jennifer R; Schieber, Lyna Z; Yusuf, Hussain; Baggs, James; Mac Kenzie, William R; Wong, Karen K; Boehmer, Tegan K; Gundlapalli, Adi V; Goodman, Alyson B.
  • Kompaniyets L; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Agathis NT; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Nelson JM; Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Preston LE; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Ko JY; US Public Health Service Commissioned Corps, Rockville, Maryland.
  • Belay B; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Pennington AF; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Danielson ML; US Public Health Service Commissioned Corps, Rockville, Maryland.
  • DeSisto CL; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Chevinsky JR; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Schieber LZ; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Yusuf H; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Baggs J; Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Mac Kenzie WR; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Wong KK; Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Boehmer TK; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Gundlapalli AV; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Goodman AB; COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.
JAMA Netw Open ; 4(6): e2111182, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1258012
Semantic information from SemMedBD (by NLM)
1. Medical Condition PROCESS_OF Child
Subject
Medical Condition
Predicate
PROCESS_OF
Object
Child
2. Medical Condition PROCESS_OF Patients
Subject
Medical Condition
Predicate
PROCESS_OF
Object
Patients
3. risk factors PROCESS_OF Child
Subject
risk factors
Predicate
PROCESS_OF
Object
Child
4. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Child
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Child
5. Medical Condition PROCESS_OF Child
Subject
Medical Condition
Predicate
PROCESS_OF
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Child
6. Medical Condition PROCESS_OF Patients
Subject
Medical Condition
Predicate
PROCESS_OF
Object
Patients
7. risk factors PROCESS_OF Child
Subject
risk factors
Predicate
PROCESS_OF
Object
Child
8. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Child
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Child
ABSTRACT
Importance Information on underlying conditions and severe COVID-19 illness among children is limited.

Objective:

To examine the risk of severe COVID-19 illness among children associated with underlying medical conditions and medical complexity. Design, Setting, and

Participants:

This cross-sectional study included patients aged 18 years and younger with International Statistical Classification of Diseases, Tenth Revision, Clinical Modification code U07.1 (COVID-19) or B97.29 (other coronavirus) during an emergency department or inpatient encounter from March 2020 through January 2021. Data were collected from the Premier Healthcare Database Special COVID-19 Release, which included data from more than 800 US hospitals. Multivariable generalized linear models, controlling for patient and hospital characteristics, were used to estimate adjusted risk of severe COVID-19 illness associated with underlying medical conditions and medical complexity. Exposures Underlying medical conditions and medical complexity (ie, presence of complex or noncomplex chronic disease). Main Outcomes and

Measures:

Hospitalization and severe illness when hospitalized (ie, combined outcome of intensive care unit admission, invasive mechanical ventilation, or death).

Results:

Among 43 465 patients with COVID-19 aged 18 years or younger, the median (interquartile range) age was 12 (4-16) years, 22 943 (52.8%) were female patients, and 12 491 (28.7%) had underlying medical conditions. The most common diagnosed conditions were asthma (4416 [10.2%]), neurodevelopmental disorders (1690 [3.9%]), anxiety and fear-related disorders (1374 [3.2%]), depressive disorders (1209 [2.8%]), and obesity (1071 [2.5%]). The strongest risk factors for hospitalization were type 1 diabetes (adjusted risk ratio [aRR], 4.60; 95% CI, 3.91-5.42) and obesity (aRR, 3.07; 95% CI, 2.66-3.54), and the strongest risk factors for severe COVID-19 illness were type 1 diabetes (aRR, 2.38; 95% CI, 2.06-2.76) and cardiac and circulatory congenital anomalies (aRR, 1.72; 95% CI, 1.48-1.99). Prematurity was a risk factor for severe COVID-19 illness among children younger than 2 years (aRR, 1.83; 95% CI, 1.47-2.29). Chronic and complex chronic disease were risk factors for hospitalization, with aRRs of 2.91 (95% CI, 2.63-3.23) and 7.86 (95% CI, 6.91-8.95), respectively, as well as for severe COVID-19 illness, with aRRs of 1.95 (95% CI, 1.69-2.26) and 2.86 (95% CI, 2.47-3.32), respectively. Conclusions and Relevance This cross-sectional study found a higher risk of severe COVID-19 illness among children with medical complexity and certain underlying conditions, such as type 1 diabetes, cardiac and circulatory congenital anomalies, and obesity. Health care practitioners could consider the potential need for close observation and cautious clinical management of children with these conditions and COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Child Health / Cardiovascular Abnormalities / Adolescent Health / Diabetes Mellitus, Type 1 / COVID-19 / Obesity Type of study: Prevalence study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article Affiliation country: Jamanetworkopen.2021.11182

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Child Health / Cardiovascular Abnormalities / Adolescent Health / Diabetes Mellitus, Type 1 / COVID-19 / Obesity Type of study: Prevalence study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article Affiliation country: Jamanetworkopen.2021.11182