Talita, Duarte-Salles; Vizcaya, David; Pistillo, Andrea; Casajust, Paula; Sena, Anthony G; Lai, Lana Yin Hui; Prats-Uribe, Albert; Ahmed, Waheed-Ul-Rahman; Alshammari, Thamir M; Alghoul, Heba; Alser, Osaid; Burn, Edward; You, Seng Chan; Areia, Carlos; Blacketer, Clair; DuVall, Scott; Falconer, Thomas; Fernandez-Bertolin, Sergio; Fortin, Stephen; Golozar, Asieh; Gong, Mengchun; Tan, Eng Hooi; Huser, Vojtech; Iveli, Pablo; Morales, Daniel R; Nyberg, Fredrik; Posada, Jose D; Recalde, Martina; Roel, Elena; Schilling, Lisa M; Shah, Nigam H; Shah, Karishma; Suchard, Marc A; Zhang, Lin; Zhang, Ying; Williams, Andrew E; Reich, Christian G; Hripcsak, George; Rijnbeek, Peter; Ryan, Patrick; Kostka, Kristin; Prieto-Alhambra, Daniel
Pediatrics
2021May ; 8 ( 3 ) :.
PMID : 34049958
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Talita, Duarte-Salles -
Vizcaya, David -
Pistillo, Andrea -
Casajust, Paula -
Sena, Anthony G -
Lai, Lana Yin Hui -
Prats-Uribe, Albert -
Ahmed, Waheed-Ul-Rahman -
Alshammari, Thamir M -
Alghoul, Heba -
Alser, Osaid -
Burn, Edward -
You, Seng Chan -
Areia, Carlos -
Blacketer, Clair -
DuVall, Scott -
Falconer, Thomas -
Fernandez-Bertolin, Sergio -
Fortin, Stephen -
Golozar, Asieh -
Gong, Mengchun -
Tan, Eng Hooi -
Huser, Vojtech -
Iveli, Pablo -
Morales, Daniel R -
Nyberg, Fredrik -
Posada, Jose D -
Recalde, Martina -
Roel, Elena -
Schilling, Lisa M -
Shah, Nigam H -
Shah, Karishma -
Suchard, Marc A -
Zhang, Lin -
Zhang, Ying -
Williams, Andrew E -
Reich, Christian G -
Hripcsak, George -
Rijnbeek, Peter -
Ryan, Patrick -
Kostka, Kristin -
Prieto-Alhambra, Daniel -
ABSTRACT
OBJECTIVES: To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children and adolescents diagnosed or hospitalized with coronavirus disease 2019 (COVID-19) and to compare them in secondary analyses with patients diagnosed with previous seasonal influenza in 2017-2018.
METHODS: International network cohort using real-world data from European primary care records (France, Germany, and Spain), South Korean claims and US claims, and hospital databases. We included children and adolescents diagnosed and/or hospitalized with COVID-19 at age <18 between January and June 2020. We described baseline demographics, comorbidities, symptoms, 30-day in-hospital treatments, and outcomes including hospitalization, pneumonia, acute respiratory distress syndrome, multisystem inflammatory syndrome in children, and death.
RESULTS: A total of 242?158 children and adolescents diagnosed and 9769 hospitalized with COVID-19 and 2?084?180 diagnosed with influenza were studied. Comorbidities including neurodevelopmental disorders, heart disease, and cancer were more common among those hospitalized with versus diagnosed with COVID-19. Dyspnea, bronchiolitis, anosmia, and gastrointestinal symptoms were more common in COVID-19 than influenza. In-hospital prevalent treatments for COVID-19 included repurposed medications (<10%) and adjunctive therapies: systemic corticosteroids (6.8%-7.6%), famotidine (9.0%-28.1%), and antithrombotics such as aspirin (2.0%-21.4%), heparin (2.2%-18.1%), and enoxaparin (2.8%-14.8%). Hospitalization was observed in 0.3% to 1.3% of the cohort diagnosed with COVID-19, with undetectable (n < 5 per database) 30-day fatality. Thirty-day outcomes including pneumonia and hypoxemia were more frequent in COVID-19 than influenza.
CONCLUSIONS: Despite negligible fatality, complications including hospitalization, hypoxemia, and pneumonia were more frequent in children and adolescents with COVID-19 than with influenza. Dyspnea, anosmia, and gastrointestinal symptoms could help differentiate diagnoses. A wide range of medications was used for the inpatient management of pediatric COVID-19. CI - Copyright ??2021 by the American Academy of Pediatrics.
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