Department of Statistics, University of Warwick, Warwick, UK.
University College London (UCL) Institute of Health Informatics, UCL, London, UK.
BMJ. 2023 Jul 5;382:e073639. doi: 10.1136/bmj-2022-073639.
To describe hospital admissions associated with SARS-CoV-2 infection in children and adolescents.
Cohort study of 3.2 million first ascertained SARS-CoV-2 infections using electronic health care record data.
England, July 2020 to February 2022.
About 12 million children and adolescents (age <18 years) who were resident in England.
Ascertainment of a first SARS-CoV-2 associated hospital admissions: due to SARS-CoV-2, with SARS-CoV-2 as a contributory factor, incidental to SARS-CoV-2 infection, and hospital acquired SARS-CoV-2.
3 226 535 children and adolescents had a recorded first SARS-CoV-2 infection during the observation period, and 29 230 (0.9%) infections involved a SARS-CoV-2 associated hospital admission. The median length of stay was 2 (interquartile range 1-4) days) and 1710 of 29 230 (5.9%) SARS-CoV-2 associated admissions involved paediatric critical care. 70 deaths occurred in which covid-19 or paediatric inflammatory multisystem syndrome was listed as a cause, of which 55 (78.6%) were in participants with a SARS-CoV-2 associated hospital admission. SARS-CoV-2 was the cause or a contributory factor in 21 000 of 29 230 (71.8%) participants who were admitted to hospital and only 380 (1.3%) participants acquired infection as an inpatient and 7855 (26.9%) participants were admitted with incidental SARS-CoV-2 infection. Boys, younger children (<5 years), and those from ethnic minority groups or areas of high deprivation were more likely to be admitted to hospital (all P<0.001). The covid-19 vaccination programme in England has identified certain conditions as representing a higher risk of admission to hospital with SARS-CoV-2: 11 085 (37.9%) of participants admitted to hospital had evidence of such a condition, and a further 4765 (16.3%) of participants admitted to hospital had a medical or developmental health condition not included in the vaccination programme's list.
Most SARS-CoV-2 associated hospital admissions in children and adolescents in England were due to SARS-CoV-2 or SARS-CoV-2 was a contributory factor. These results should inform future public health initiatives and research.
描述与 SARS-CoV-2 感染相关的儿童和青少年住院病例。
使用电子医疗记录数据对 320 万例首次确诊 SARS-CoV-2 感染的患者进行队列研究。
2020 年 7 月至 2022 年 2 月期间，英格兰。
约 1200 万居住在英格兰的儿童和青少年（年龄<18 岁）。
首次 SARS-CoV-2 相关住院病例的确诊：由 SARS-CoV-2 引起、SARS-CoV-2 为促成因素、SARS-CoV-2 感染的偶然并发症、医院获得性 SARS-CoV-2。
在观察期间，3226535 例儿童和青少年记录到首次 SARS-CoV-2 感染，29230 例（0.9%）感染与 SARS-CoV-2 相关住院有关。中位住院时间为 2 天（四分位距 1-4 天），29230 例 SARS-CoV-2 相关住院中有 1710 例涉及儿科重症监护。70 例死亡病例中，新冠病毒病或儿童炎症性多系统综合征被列为死因，其中 55 例（78.6%）发生在 SARS-CoV-2 相关住院患者中。21000 例（71.8%）住院患者的 SARS-CoV-2 是病因或促成因素，只有 380 例（1.3%）患者作为住院患者获得感染，7855 例（26.9%）患者因偶然感染 SARS-CoV-2 而住院。男孩、年龄较小的儿童（<5 岁）、少数族裔或高贫困地区的儿童更有可能住院（均 P<0.001）。英格兰的新冠病毒病疫苗接种计划确定了某些疾病状态作为与 SARS-CoV-2 住院相关的更高风险因素：住院的 11085 例（37.9%）患者有此类疾病状态的证据，另有 4765 例（16.3%）住院患者患有疫苗接种计划清单中未包含的医疗或发育健康状况。
英格兰儿童和青少年中大多数与 SARS-CoV-2 相关的住院病例是由 SARS-CoV-2 引起的，或 SARS-CoV-2 是促成因素。这些结果应有助于未来的公共卫生计划和研究。
