Hospitalization for COVID-19 and Risk Factors for Severe Disease Among Children: 2022-2024.

作者信息

Free Rebecca J, Patel Kadam, Taylor Christopher A, Sachdev Darpun, Kawasaki Breanna, Meek James, Openo Kyle P, Ryan Patricia A, Reeg Libby, D'Heilly Paige, Smelser Chad, Engesser Kerianne, Tesini Brenda L, Sutton Melissa, Keipp Talbot H, Swain Ashley, Campbell Angela P, Havers Fiona P

机构信息

Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia.

California Department of Public Health, Richmond, California.

出版信息

Pediatrics. 2025 Sep 1;156(3). doi: 10.1542/peds.2025-072788.

OBJECTIVES

We assessed characteristics associated with pediatric COVID-19 hospitalizations and risk factors for severe disease among hospitalized children aged 6 months and older.

METHODS

Using data from COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) during October 1, 2022, to April 30, 2024, we described demographic characteristics, underlying medical conditions, COVID-19 vaccination status, and clinical outcomes, including severe disease (intensive care unit admission, mechanical ventilation, extracorporeal membrane oxygenation, in-hospital death), of hospitalized children aged 6 months to 17 years residing in the COVID-NET catchment area with laboratory-confirmed SARS-CoV-2 infection. Multivariable log-linked Poisson generalized estimating equations were conducted to assess risk factors for severe disease among children aged 6 to 23 months and 2 to 17 years.

RESULTS

Of 2490 children hospitalized for COVID-19, 1114 (44.7%) were aged 6 to 23 months; 1358 (54.1%) were male. Overall, 1464 (58.9%) had at least 1 underlying condition: 471 (41.8%) of children aged 6 to 23 months, 290 (61.6%) aged 2 to 4 years, 383 (79.2%) aged 5 to 11 years, and 320 (77.0%) aged 12 to 17 years. One hundred (3.8%) were up to date with recommended COVID-19 vaccination. Among children aged 6 to 23 months, severe disease was associated with underlying chronic lung (adjusted risk ratio [aRR], 1.5; 95% CI, 1.2-1.8) and cardiovascular disease (aRR, 1.4; 95% CI, 1.1-1.7). Among children aged 2 years and older, severity was associated with chronic lung disease (aRR, 1.9; 95% CI, 1.5-2.3), diabetes (aRR, 1.5; 95% CI, 1.2-1.8), and neurologic disorders (aRR, 1.4; 95% CI, 1.2-1.6).

CONCLUSION

Most hospitalized children aged 6 months and older had at least 1 underlying condition, and less than 5% were up to date with COVID-19 vaccination. Specific conditions were associated with increased risk of severe illness. Increasing COVID-19 vaccination, particularly among children with high-risk conditions, may reduce pediatric COVID-19 hospitalizations and severe outcomes.