Naïm Ouldali1,2,3,4, David Dawei Yang5, Fouad Madhi4,6, Michael Levy7, Jean Gaschignard1, Irina Craiu8, Tamazoust Guiddir8, Cyril Schweitzer9, Arnaud Wiedemann9, Mathie Lorrot10, Anne-Sophie Romain10, Aurélie Garraffo11, Hervé Haas12, Sébastien Rouget13, Loïc de Pontual14, Camille Aupiais14,15, Alain Martinot16, Julie Toubiana17, Laurent Dupic18, Philippe Minodier19, Manon Passard20, Alexandre Belot21, Corinne Levy2,4, Stephane Béchet2, Camille Jung22, Mayssa Sarakbi23, Sarah Ducrocq24, Nevena Danekova25, Imen Jhaouat26, Olivier Vignaud27, Nathalie Garrec28, Elisabeth Caron29, Robert Cohen2,4,30, Vincent Gajdos31,32, François Angoulvant33,5,15. 1. Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Université de Paris, Paris, France. 2. Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France. 3. Université de Paris, Institut National de la Santé et de la Recherche Médicale UMR 1123, ECEVE, Paris, France. 4. French Pediatric Infectious Disease Group, Paris, France. 5. Pediatric Emergency Department, Assistance Publique - Hôpitaux de Paris, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France. 6. Pediatric Department, Centre Hospitalier Intercommunal. 7. Pediatric ICU, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Université de Paris, Paris, France. 8. Pediatric Emergency Department, Assistance Publique - Hôpitaux de Paris, Bicêtre University Hospital, Université de Paris Saclay, Le Kremlin-Bicêtre, France. 9. Pediatric Department, Children's Hospital, University Hospital of Nancy, Université de Lorraine, Vandoeuvre les Nancy, France. 10. Department of General Pediatric, Assistance Publique - Hôpitaux de Paris, Armand Trousseau University Hospital, Sorbonne Université, Paris, France. 11. Department of Pediatrics, Centre Hospitalier Intercommunal de Villeneuve Saint-Georges, Villeneuve Saint-Georges, France. 12. Pediatric Emergency Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France. 13. Pediatric Department, Centre Hospitalier Sud-Francilien, Corbeil, France. 14. Pediatric Emergency Departement, Assistance Publique-Hôpitaux de Paris - General Pediatric, Jean Verdier University Hospital, Bondy, France. 15. Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France. 16. Pediatric Emergency Unit and Infectious Diseases, Centre Hospitalier Universitaire Lille, Université de Lille, Lille, France. 17. Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Necker-Enfants-Malades University Hospital, Université de Paris, & Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France. 18. Pediatric ICU, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France. 19. Pediatric Emergency Department, Assistance Publique - Hôpitaux de Marseille, Marseille Nord University Hospital, Marseille, France. 20. Pediatric Emergency Department, Hospices Civils de Lyon, Hopital Femme, Mère Enfant, Bron, France. 21. Pediatric Nephrology, Rheumatology, Dermatology, Hospices Civils de Lyon, Hopital Femme, Mère Enfant, & Centre International de Recherche en Infectiologie/Institut National de la Santé et de la Recherche Médicale U1111, Bron, France. 22. Centre Hospitalier Intercommunal, Clinical Research Center, and. 23. Department of Pediatrics, Centre Hospitalier Intercommunal de Gonesse, Gonesse, France. 24. Department of Pediatrics, Centre hospitalier de Longjumeau, Longjumeau, France. 25. Pediatric Emergency Departement, Assistance Publique - Hôpitaux de Paris, Louis Mourier University Hospital, Colombes, France. 26. Department of Pediatrics, Centre hospitalier d'Orléans, Orléans, France. 27. Department of Pediatrics, Grand Hôpital de l'Est Francilien, Meaux, France. 28. Department of Pediatrics, Grand Hôpital de l'Est Francilien, Marnes la vallée, France. 29. Department of Pediatrics, Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye, Poissy, France. 30. Neonates Department, Centre Hospitalier Intercommunal, Université Paris Est, IMRB-GRC GEMINI, Créteil, France. 31. Pediatric Department, Assistance Publique - Hôpitaux de Paris, Antoine Béclère University hospital, Université de Paris Saclay, Clamart, France; and. 32. Centre for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale UMR1018, Villejuif, France. 33. French Pediatric Infectious Disease Group, Paris, France; francois.angoulvant@aphp.fr.
Abstract
BACKGROUND: Initial reports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in children suggested that very young age and comorbidities may increase risk of severe evolution, but these findings remained to be confirmed. We aimed to analyze the clinical spectrum of hospitalized pediatric SARS-CoV-2 infection and predictors of severe disease evolution. METHODS: We conducted a French national prospective surveillance of children hospitalized with SARS-CoV-2 infection. We included all children with confirmed SARS-CoV-2 infection in 60 hospitals during February 15 to June 1, 2020. The main outcome was the proportion of children with severe disease, defined by hemodynamic or ventilatory (invasive or not) support requirement. RESULTS: We included 397 hospitalized children with SARS-CoV-2 infection. We identified several clinical patterns, ranging from paucisymptomatic children, admitted for surveillance, to lower respiratory tract infection or multisystem inflammatory syndrome in children. Children <90 days old accounted for 37% of cases (145 of 397), but only 4 (3%) had severe disease. Excluding children with multisystem inflammatory syndrome in children (n = 29) and hospitalized for a diagnosis not related to SARS-CoV-2 (n = 62), 23 of 306 (11%) children had severe disease, including 6 deaths. Factors independently associated with severity were age ≥10 years (odds ratio [OR] = 3.4, 95% confidence interval: 1.1-10.3), hypoxemia (OR = 8.9 [2.6-29.7]), C-reactive protein level ≥80 mg/L (OR = 6.6 [1.4-27.5]). CONCLUSIONS: In contrast with preliminary reports, young age was not an independent factor associated with severe SARS-CoV-2 infection, and children <90 days old were at the lowest risk of severe disease evolution. This may help physicians to better identify risk of severe disease progression in children.
BACKGROUND: Initial reports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in children suggested that very young age and comorbidities may increase risk of severe evolution, but these findings remained to be confirmed. We aimed to analyze the clinical spectrum of hospitalized pediatric SARS-CoV-2 infection and predictors of severe disease evolution. METHODS: We conducted a French national prospective surveillance of children hospitalized with SARS-CoV-2 infection. We included all children with confirmed SARS-CoV-2 infection in 60 hospitals during February 15 to June 1, 2020. The main outcome was the proportion of children with severe disease, defined by hemodynamic or ventilatory (invasive or not) support requirement. RESULTS: We included 397 hospitalized children with SARS-CoV-2 infection. We identified several clinical patterns, ranging from paucisymptomatic children, admitted for surveillance, to lower respiratory tract infection or multisystem inflammatory syndrome in children. Children <90 days old accounted for 37% of cases (145 of 397), but only 4 (3%) had severe disease. Excluding children with multisystem inflammatory syndrome in children (n = 29) and hospitalized for a diagnosis not related to SARS-CoV-2 (n = 62), 23 of 306 (11%) children had severe disease, including 6 deaths. Factors independently associated with severity were age ≥10 years (odds ratio [OR] = 3.4, 95% confidence interval: 1.1-10.3), hypoxemia (OR = 8.9 [2.6-29.7]), C-reactive protein level ≥80 mg/L (OR = 6.6 [1.4-27.5]). CONCLUSIONS: In contrast with preliminary reports, young age was not an independent factor associated with severe SARS-CoV-2 infection, and children <90 days old were at the lowest risk of severe disease evolution. This may help physicians to better identify risk of severe disease progression in children.
Authors: James W Antoon; Carlos G Grijalva; Cary Thurm; Troy Richardson; Alicen B Spaulding; Ronald J Teufel; Mario A Reyes; Samir S Shah; Julianne E Burns; Chén C Kenyon; Adam L Hersh; Derek J Williams Journal: J Hosp Med Date: 2021-10 Impact factor: 2.899
Authors: Amanda B Payne; Zunera Gilani; Shana Godfred-Cato; Ermias D Belay; Leora R Feldstein; Manish M Patel; Adrienne G Randolph; Margaret Newhams; Deepam Thomas; Reed Magleby; Katherine Hsu; Meagan Burns; Elizabeth Dufort; Angie Maxted; Michael Pietrowski; Allison Longenberger; Sally Bidol; Justin Henderson; Lynn Sosa; Alexandra Edmundson; Melissa Tobin-D'Angelo; Laura Edison; Sabrina Heidemann; Aalok R Singh; John S Giuliano; Lawrence C Kleinman; Keiko M Tarquinio; Rowan F Walsh; Julie C Fitzgerald; Katharine N Clouser; Shira J Gertz; Ryan W Carroll; Christopher L Carroll; Brooke E Hoots; Carrie Reed; F Scott Dahlgren; Matthew E Oster; Timmy J Pierce; Aaron T Curns; Gayle E Langley; Angela P Campbell; Neha Balachandran; Thomas S Murray; Cole Burkholder; Troy Brancard; Jenna Lifshitz; Dylan Leach; Ian Charpie; Cory Tice; Susan E Coffin; Dana Perella; Kaitlin Jones; Kimberly L Marohn; Phoebe H Yager; Neil D Fernandes; Heidi R Flori; Monica L Koncicki; Karen S Walker; Maria Cecilia Di Pentima; Simon Li; Steven M Horwitz; Sunanda Gaur; Dennis C Coffey; Ilana Harwayne-Gidansky; Saul R Hymes; Neal J Thomas; Kate G Ackerman; Jill M Cholette Journal: JAMA Netw Open Date: 2021-06-01
Authors: Blake Martin; Peter E DeWitt; Seth Russell; Adit Anand; Katie R Bradwell; Carolyn Bremer; Davera Gabriel; Andrew T Girvin; Janos G Hajagos; Julie A McMurry; Andrew J Neumann; Emily R Pfaff; Anita Walden; Jacob T Wooldridge; Yun Jae Yoo; Joel Saltz; Ken R Gersing; Christopher G Chute; Melissa A Haendel; Richard Moffitt; Tellen D Bennett Journal: medRxiv Date: 2021-07-23