Risk factors for severe disease and mortality in children with COVID-19

Abstract

Background: Pediatric COVID-19 patients have lower rates of hospitalization and fatal outcomes compared to adults with COVID-19; however, children represent a challenge in the detection, diagnosis, and treatment of COVID-19. Our aim was to determine the risk factors for hospital admission, invasive mechanical ventilation, and mortality in pediatric COVID-19 patients in Mexico during the COVID-19 pandemic. Material and methods: A retrospective cohort of pediatric patients with COVID-19 from February 2020 to April 2021 was reported on the National Epidemiological Surveillance System for Viral Respiratory Disease (SISVER) platform. Results: Among the 104,133 patients included in our study, 6214 were hospitalized, and 621 patients underwent invasive mechanical ventilation. A total of 0.65 % died during hospitalization. Children aged <12 months (odds ratio [OR]: 17.1; 95 % confidence interval [CI]: 15.9–19.4, p < 0.001), 1–4 years (OR: 3.69; 95 % CI: 3.2–4.1, p < 0.001), 5–9 years (OR: 1.86; 95 % CI: 1.66–2.08, p < 0.001), and 10–14 years (OR: 1.23; 95 % CI: 1.11–1.37, p < 0.001), and those diagnosed with diabetes (OR: 2.32; 95 % CI 1.68–3.20, p < 0.001) and obesity (OR: 1.24; 95 % CI 1.04–1.48, p = 0.015) were associated with hospital admission. Renal disease (OR: 3.85; 95 % CI: 2.25–6.59, p < 0.001) was associated with invasive mechanical ventilation. Pneumonia (OR: 15.9; 95 % CI: 12.6–20.1, p < 0.001) and renal disease (OR: 3.85; 95 % CI: 2.25–6.59, p value < 0.001) were associated with death. Conclusion: Pneumonia increases the risk of death. The youngest age group has a higher risk of hospital admission. Comorbidities such as renal disease or immunosuppression increase the risk of death in all age groups.

Keywords

• Risk factors
• Pediatrics
• Mortality
• COVID-19
• Hospital admission