Children's Hospital of Orange County, Orange, CA, USA.
University of California-Irvine Department of Surgery, Orange, CA, USA.
Pediatr Res. 2024 Aug;96(3):792-798. doi: 10.1038/s41390-024-03076-9. Epub 2024 Feb 16.
Congenital heart defects are known to be associated with increased odds of severe COVID-19. Congenital anomalies affecting other body systems may also be associated with poor outcomes. This study is an exhaustive assessment of congenital anomalies and odds of severe COVID-19 in pediatric patients.
Data were retrieved from the COVID-19 dataset of Cerner® Real-World Data for encounters from March 2020 to February 2022. Prior to matching, the data consisted of 664,523 patients less than 18 years old and 927,805 corresponding encounters with COVID-19 from 117 health systems across the United States. One-to-one propensity score matching was performed, and a cumulative link mixed-effects model with random intercepts for health system and patients was built to assess corresponding associations.
All congenital anomalies were associated with worse COVID-19 outcomes, with the strongest association observed for cardiovascular anomalies (odds ratio [OR], 3.84; 95% CI, 3.63-4.06) and the weakest association observed for anomalies affecting the eye/ear/face/neck (OR, 1.16; 95% CI, 1.03-1.31).
Congenital anomalies are associated with greater odds of experiencing severe symptoms of COVID-19. In addition to congenital heart defects, all other birth defects may increase the odds for more severe COVID-19.
All congenital anomalies are associated with increased odds of severe COVID-19. This study is the largest and among the first to investigate birth defects across all body systems. The multicenter large data and analysis demonstrate the increased odds of severe COVID19 in pediatric patients with congenital anomalies affecting any body system. These data demonstrate that all children with birth defects are at increased odds of more severe COVID-19, not only those with heart defects. This should be taken into consideration when optimizing prevention and intervention resources within a hospital.
先天性心脏病已知与 COVID-19 重症的几率增加有关。影响其他身体系统的先天性异常也可能与不良结局相关。本研究全面评估了儿科患者的先天性异常和 COVID-19 重症的几率。
数据来自 Cerner®真实世界数据中的 COVID-19 数据集，包括 2020 年 3 月至 2022 年 2 月期间的就诊记录。在匹配之前，数据包含 664523 名年龄小于 18 岁的患者和来自美国 117 个卫生系统的 927805 例 COVID-19 对应的就诊记录。进行了一对一倾向评分匹配，并建立了具有健康系统和患者随机截距的累积链接混合效应模型，以评估相应的关联。
所有先天性异常均与 COVID-19 结局较差相关，心血管异常的关联最强（比值比 [OR]，3.84；95%置信区间 [CI]，3.63-4.06），而影响眼/耳/面/颈部的异常的关联最弱（OR，1.16；95%CI，1.03-1.31）。
先天性异常与 COVID-19 出现严重症状的几率增加相关。除先天性心脏病外，所有其他先天性缺陷都可能增加 COVID-19 更严重的几率。
所有先天性异常均与 COVID-19 重症的几率增加相关。本研究是规模最大的、首批调查所有身体系统先天性缺陷的研究之一。多中心大样本数据和分析表明，患有影响任何身体系统的先天性异常的儿科患者 COVID-19 重症的几率增加。这些数据表明，所有患有先天性缺陷的儿童 COVID-19 更严重的几率增加，不仅是心脏缺陷的儿童。在医院内优化预防和干预资源时应考虑到这一点。
