Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California, USA.
Department of Pediatrics, Kaiser Permanente Northern California, Oakland, California, USA.
Influenza Other Respir Viruses. 2024 Oct;18(10):e70022. doi: 10.1111/irv.70022.
The aim of this study is to determine the incidence and risk factors associated with COVID-19 hospitalization among unvaccinated children.
Children aged 0- < 18 years, members of Kaiser Permanente Northern California (KPNC), were followed from March 1, 2020, until the earliest occurrence of: chart-confirmed COVID-19 hospitalization, disenrollment from KPNC, age 18 years, receipt of COVID-19 vaccine, death, or study end (December 31, 2022). We calculated the incidence rate of hospitalization by SARS-CoV-2 variant period and by age group. We determined risk factors for hospitalization using Poisson regression. We also conducted descriptive analyses of hospitalized cases.
Among 1,107,799 children, 423 were hospitalized for COVID-19 during follow-up. The incidence of hospitalization increased with each new SARS-CoV-2 variant and was highest among children aged < 6 months. Among the < 6-month-olds, the incidence rate per 100,000 person-months was 7 during predelta, 13.3 during delta, and 22.4 during omicron. Black (RR = 2.05, 95% CI: 1.33-3.16) and Hispanic children (RR = 1.82, 95% CI: 1.34-2.46) and children with any comorbidities were at high risk of hospitalization (RR = 3.81, 95% CI: 2.94-4.95). Overall, 20.3% of hospitalized children were admitted to an intensive care unit (ICU), but ICU admission was 36.1% among 12- < 18-year-olds. The majority of ICU admits (91.8%) had no comorbidities.
Children too young to be vaccinated had the highest incidence of COVID-19 hospitalization, while adolescents had the highest proportion of ICU admissions. To prevent severe disease in children and adolescents, everyone eligible should be vaccinated.
本研究旨在确定未接种疫苗儿童中与 COVID-19 住院相关的发病率和风险因素。
2020 年 3 月 1 日起，对加利福尼亚州 Kaiser Permanente 北部（KPNC）的 0-<18 岁儿童进行随访，直至以下情况最早发生：经图表确认的 COVID-19 住院、从 KPNC 退出、年满 18 岁、接种 COVID-19 疫苗、死亡或研究结束（2022 年 12 月 31 日）。我们按 SARS-CoV-2 变体期和年龄组计算住院率。我们使用泊松回归确定住院的风险因素。我们还对住院病例进行了描述性分析。
在 1107799 名儿童中，有 423 名在随访期间因 COVID-19 住院。随着新 SARS-CoV-2 变体的出现，住院率不断增加，<6 个月的儿童住院率最高。在<6 个月的儿童中，每 10 万人月的发病率分别为德尔塔之前的 7 例、德尔塔的 13.3 例和奥密克戎的 22.4 例。黑人（RR=2.05，95%CI：1.33-3.16）和西班牙裔儿童（RR=1.82，95%CI：1.34-2.46）以及有任何合并症的儿童住院风险较高（RR=3.81，95%CI：2.94-4.95）。总体而言，20.3%的住院患儿被收治于重症监护病房（ICU），但 12-<18 岁患儿的 ICU 入院率为 36.1%。大多数 ICU 患者（91.8%）无合并症。
太小而无法接种疫苗的儿童 COVID-19 住院率最高，而青少年 ICU 入院率最高。为预防儿童和青少年的重症疾病，应让所有符合条件的人接种疫苗。
