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Risk factors for PICU admission and death among children and young people hospitalized with COVID-19 and PIMS-TS in England during the first pandemic year.
Ward, Joseph L; Harwood, Rachel; Smith, Clare; Kenny, Simon; Clark, Matthew; Davis, Peter J; Draper, Elizabeth S; Hargreaves, Dougal; Ladhani, Shamez; Linney, Michael; Luyt, Karen; Turner, Steve; Whittaker, Elizabeth; Fraser, Lorna K; Viner, Russell M.
  • Ward JL; UCL Great Ormond St. Institute of Child Health, London, UK. joseph.ward@ucl.ac.uk.
  • Harwood R; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
  • Smith C; Dept of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
  • Kenny S; NHS England and Improvement, Leeds, UK.
  • Clark M; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
  • Davis PJ; Dept of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
  • Draper ES; NHS England and Improvement, Leeds, UK.
  • Hargreaves D; NHS England and Improvement, Leeds, UK.
  • Ladhani S; NHS England and Improvement, Leeds, UK.
  • Linney M; Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK.
  • Luyt K; PICANet, Department of Health Sciences, University of Leicester, Leicester, UK.
  • Turner S; Mohn Centre for Children's Health and Wellbeing, Imperial College London, London, UK.
  • Whittaker E; Immunisation and Countermeasures, Public Health England, London, UK.
  • Fraser LK; University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
  • Viner RM; National Child Mortality Database, Bristol Medical School, University of Bristol, Bristol, UK.
Nat Med ; 28(1): 193-200, 2022 01.
Article in English | MEDLINE | ID: covidwho-1585817
ABSTRACT
Identifying which children and young people (CYP) are most vulnerable to serious infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to guide protective interventions. To address this question, we used data for all hospitalizations in England among 0-17 year olds from 1 February 2019 to 31 January 2021. We examined how sociodemographic factors and comorbidities might be risk factors for pediatric intensive care unit (PICU) admission among hospitalizations due to the following causes Coronavirus Disease 2019 (COVID-19) and pediatric inflammatory multi-system syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the first pandemic year (2020-2021); hospitalizations due to all other non-traumatic causes in 2020-2021; hospitalizations due to all non-traumatic causes in 2019-2020; and hospitalizations due to influenza in 2019-2020. Risk of PICU admission and death from COVID-19 or PIMS-TS in CYP was very low. We identified 6,338 hospitalizations with COVID-19, of which 259 were admitted to a PICU and eight CYP died. We identified 712 hospitalizations with PIMS-TS, of which 312 were admitted to a PICU and fewer than five CYP died. Hospitalizations with COVID-19 and PIMS-TS were more common among males, older CYP, those from socioeconomically deprived neighborhoods and those who were of non-White ethnicity (Black, Asian, Mixed or Other). The odds of PICU admission were increased in CYP younger than 1 month old and decreased among 15-17 year olds compared to 1-4 year olds with COVID-19; increased in older CYP and females with PIMS-TS; and increased for Black compared to White ethnicity in patients with COVID-19 and PIMS-TS. Odds of PICU admission in COVID-19 were increased for CYP with comorbidities and highest for CYP with multiple medical problems. Increases in odds of PICU admission associated with different comorbidities in COVID-19 showed a similar pattern to other causes of hospitalization examined and, thus, likely reflect background vulnerabilities. These findings identify distinct risk factors associated with PICU admission among CYP with COVID-19 or PIMS-TS that might aid treatment and prevention strategies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intensive Care Units, Pediatric / Ethnicity / Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Country/Region as subject: Europa Language: English Journal: Nat Med Journal subject: Molecular Biology / Medicine Year: 2022 Document Type: Article Affiliation country: S41591-021-01627-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intensive Care Units, Pediatric / Ethnicity / Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Country/Region as subject: Europa Language: English Journal: Nat Med Journal subject: Molecular Biology / Medicine Year: 2022 Document Type: Article Affiliation country: S41591-021-01627-9