Age, Chronic Conditions, Comorbidities Impact COVID-19 in Children

At Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center, a group of physicians has identified older age, chronic conditions, and comorbidities as risk factors for severe COVID-19 in children.

Throughout the pandemic, researchers have acknowledged significant differences in COVID-19 between children and adults. While risk factors for hospitalizations and poor outcomes are well studied among adult populations, less is known about clinical factors linked to severe COVID-19 in children.

To create a mitigation strategy for children at high risk of developing severe cases, the Vanderbilt physicians studied the data of 20,000 patients from 45 children’s hospitals around the United States.

“This is one of the largest multicenter studies of children with COVID-19 in the United States,” assistant professor of Pediatrics at Children’s Hospital and lead author of the study, James Antoon, MD, PhD, FAAP, said in a press release.

“And given the recent, concerning increases in COVID cases nationwide and the fact that the vast majority of children remain unvaccinated and susceptible, these findings should be taken into account when considering preventive strategies in schools and planning vaccinations when available for children less than 12 years of age.”

Through the study, researchers determined that older age and chronic comorbidities such as obesity, diabetes, and neurologic conditions were associated with severe COVID-19 and poor health outcomes.

“These factors help identify vulnerable children who are most likely to require hospitalization or develop severe COVID-19 disease,” said Antoon. “Our findings also highlight children who should be prioritized for COVID-19 vaccines when approved by the FDA.”

In the retrospective cohort study, approximately one in four children admitted into the hospital with COVID-19 developed a severe case and required ICU care during April and September 2020.

“Across the country, there is a raging debate on how best to protect children and schools from COVID-19,” said Antoon. “Some children are at increased risk for more severe disease and many of them are not yet eligible for vaccination against COVID.”

“With schools opening and some already in session, these children need to be protected by vaccinating as many people as possible while also using practical strategies to limit spread, such as masking, distancing, and ventilation.”

The study investigators hope their findings will lead to mitigation efforts proven beneficial for children and adolescents during the pandemic, such as remote learning, social distancing, handwashing, and mask-wearing both for students and teachers.