Factors Linked to Severe COVID-19 in Children Identified
8 percent of children need ICU admission; risk up with age <;1 month, male sex, pre-existing conditions
MONDAY, June 29, 2020 (HealthDay News) -- COVID-19 generally causes mild disease in children, with 8 percent of children requiring intensive care unit (ICU) admission, according to a study published online June 25 in The Lancet Child & Adolescent Health.
Florian Götzinger, M.D., from the National Reference Center for Childhood Tuberculosis in Vienna, and colleagues conducted a multicenter cohort study involving 582 individuals aged 18 years or younger with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, detected between April 1 and April 24, 2020.
The researchers found that 48 individuals (8 percent) required ICU admission, 25 (4 percent) required mechanical ventilation, 19 (3 percent) required inotropic support, and one (<1 percent) required extracorporeal membrane oxygenation. In multivariate analyses, factors significantly associated with requiring ICU admission included being younger than 1 month, male sex, having pre-existing medical conditions, and presence of lower respiratory tract infection signs or symptoms at presentation (odds ratios, 5.06, 2.12, 3.27, and 10.46, respectively). Hydroxychloroquine was the most frequently used drug with antiviral activity (7 percent), followed by remdesivir, lopinavir-ritonavir, and oseltamivir (3, 1, and 1 percent, respectively). At the study end, four children died (case fatality rate, 0.69 percent); 578 were alive and 25 (4 percent) were still symptomatic or required respiratory support.
"Although COVID-19 affects children less severely than adults overall, our study shows that there are severe cases in all age groups. Those who have pre-existing health issues and children under one month of age were more likely to be admitted to intensive care," Götzinger said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.