Miranda J Delahoy1,2,3, Dawud Ujamaa1,2, Christopher A Taylor1, Charisse Cummings1,2, Onika Anglin1, Rachel Holstein1,2, Jennifer Milucky1, Alissa O'Halloran1,2, Kadam Patel1, Huong Pham1, Michael Whitaker1, Arthur Reingold4,5, Shua J Chai4,6, Nisha B Alden7, Breanna Kawasaki7, James Meek8, Kimberly Yousey-Hindes8, Evan J Anderson9,10,11, Kyle P Openo9,10,11, Andy Weigel12, Kenzie Teno12, Libby Reeg13, Lauren Leegwater13, Ruth Lynfield14, Melissa McMahon14, Susan Ropp15, Dominic Rudin15, Alison Muse16, Nancy Spina16, Nancy M Bennett17, Kevin Popham18, Laurie M Billing19, Eli Shiltz19, Melissa Sutton20, Ann Thomas20, William Schaffner21, H Keipp Talbot21, Melanie T Crossland22, Keegan McCaffrey23, Aron J Hall1, Erin Burns2, Meredith McMorrow1, Carrie Reed2, Fiona P Havers1, Shikha Garg1,2. 1. CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, United States. 2. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States. 3. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States. 4. California Emerging Infections Program, Oakland, California, United States. 5. University of California, Berkeley School of Public Health, Berkeley, California, United States. 6. Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, Georgia, United States. 7. Colorado Department of Public Health and Environment, Denver, Colorado, United States. 8. Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, United States. 9. Emory University School of Medicine, Atlanta, Georgia, United States. 10. Georgia Emerging Infections Program, Georgia Department of Health, Atlanta, Georgia, United States. 11. Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, United States. 12. Iowa Department of Health, Des Moines, Iowa, United States. 13. Michigan Department of Health and Human Services, Lansing, Michigan, United States. 14. Minnesota Department of Health, Saint Paul, Minnesota, United States. 15. New Mexico Emerging Infections Program, New Mexico Department of Health, Santa Fe, New Mexico, United States. 16. New York State Department of Health, Albany, New York, United States. 17. University of Rochester School of Medicine and Dentistry, Rochester, New York, United States. 18. Rochester Emerging Infections Program, University of Rochester Medical Center, Rochester, New York, United States. 19. Ohio Department of Health, Columbus, Ohio, United States. 20. Public Health Division, Oregon Health Authority, Salem, Oregon, United States. 21. Vanderbilt University Medical Center, Nashville, Tennessee, United States. 22. Salt Lake County Health Department, Salt Lake City, Utah, United States. 23. Utah Department of Health, Salt Lake City, Utah, United States.
Abstract
BACKGROUND: Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. METHODS: Influenza and COVID-19-associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, two population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19-associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (October 1, 2020-September 30, 2021) was compared to influenza-associated hospitalization rates during the 2017-18 through 2019-20 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. RESULTS: Among children <18 years old, the COVID-19-associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017-18 (33.5), 2018-19 (33.8), and 2019-20 (41.7). The COVID-19-associated hospitalization rate was higher among adolescents 12-17 years old (COVID-19: 59.9; influenza range: 12.2-14.1), but similar or lower among children 5-11 (COVID-19: 25.0; influenza range: 24.3-31.7) and 0-4 (COVID-19: 66.8; influenza range: 70.9-91.5) years old. Among children <18 years old, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; p < 0.01). Pediatric deaths were uncommon during both COVID-19- and influenza-associated hospitalizations (0.7% vs 0.5%; p = 0.28). CONCLUSIONS: In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19-associated hospitalization rate during 2020-2021 was higher among adolescents and similar or lower among children <12 years old compared with influenza during the three seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses.
BACKGROUND: Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. METHODS: Influenza and COVID-19-associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, two population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19-associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (October 1, 2020-September 30, 2021) was compared to influenza-associated hospitalization rates during the 2017-18 through 2019-20 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. RESULTS: Among children <18 years old, the COVID-19-associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017-18 (33.5), 2018-19 (33.8), and 2019-20 (41.7). The COVID-19-associated hospitalization rate was higher among adolescents 12-17 years old (COVID-19: 59.9; influenza range: 12.2-14.1), but similar or lower among children 5-11 (COVID-19: 25.0; influenza range: 24.3-31.7) and 0-4 (COVID-19: 66.8; influenza range: 70.9-91.5) years old. Among children <18 years old, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; p < 0.01). Pediatric deaths were uncommon during both COVID-19- and influenza-associated hospitalizations (0.7% vs 0.5%; p = 0.28). CONCLUSIONS: In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19-associated hospitalization rate during 2020-2021 was higher among adolescents and similar or lower among children <12 years old compared with influenza during the three seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses.