• Article
  • May 19, 2020

COVID-19 Severity High in Children

New research shows pediatric population at higher risk for hospitalization, critical care than originally thought.

As the novel coronavirus (COVID-19) began to spread across the U.S., much of the public health focus was in preventing infection among elderly and immunocompromised adults. Early data suggested children were not at high risk of infection or serious illness from the virus, so most of the attention on the pediatric population has been focused primarily on its potential role in influencing spread and community transmission of the disease.

However, newly released research suggests children are at a much higher risk of severe illness from COVID-19 than originally believed.

High hospitalization rate, fewer underlying conditions among study results

In the first peer-reviewed published report summarizing severe COVID-19 implications from a United States pediatric center, researchers at Children’s National Hospital in Washington, D.C., report a significant number of children and young adults requiring hospitalization and critical care—contrary to published and anecdotal reports from elsewhere around the country and the world.

The researchers analyzed 177 confirmed COVID-19 cases of children and young adults at Children’s National from mid-March to the end of April. Among their key findings:

  • 25% of the patients required hospitalization with 5% needing critical care, including intubation and mechanical ventilation.
  • More than half of the patients—including 37% of the hospitalized and 22% of critically ill patients—had no underlying conditions.
  • Although asthma was the most common underlying condition present in the overall group, children and young adults with asthma were not over-represented in the hospitalized cohort or in the critically ill cohort.

Hospitals should be prepared for more severely ill children

The report notes the higher severity of COVID-19 shown in the study could be due to some regional factors, including density and ethnic makeup of the population in the Washington, D.C. area. Accounting for those factors—along with the continued spread of the virus—the Children’s National researchers plan further data gathering and analysis.

But the study highlights the potential for severe disease among the pediatric population and its researchers advise children’s hospitals across the country to inform their COVID-19 response to include the potential for “a significant burden” of hospitalized and critically ill children and young adults.

Read the full text of the report.

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