Research continues to suggest that children may be less likely to experience severe illness as a result of the novel coronavirus. This week, a new study on children hospitalized with coronavirus found that while COVID-19 can result in a significant disease burden and kids are not immune to the virus, children tend to experience severe illness less frequently and had better early hospital outcomes than adults.
The study, which was published Monday in JAMA Pediatrics, followed the care of 48 children hospitalized for COVID-19 between March 14 and April 3 at 14 pediatric intensive care units (PICUs) in the United States. While the study had initially sought to examine COVID-19 cases at 46 PICUs spread across North America, researchers found that not every PICU had seen a COVID-19 case early in the pandemic.
"It is notable that only 35% of the hospitals participating in the study reported admissions of children with COVID-19 infection to the PICU, and there were no COVID-19 admissions to Canadian PICUs during the study period," researchers noted.
Of the 48 children hospitalized for COVID-19 in the United States, however, researchers found that 83% had pre-existing underlying conditions. Upon admission, 69% of the children were reported to be severely or critically ill and 73% presented with respiratory symptoms. A majority of children — 81% — required respiratory support beyond their baseline. While doctors were able to manage the respiratory care of 44% of those children non-invasively, 38% required invasive endotracheal or tracheostomy ventilation. Of the 48 children, 23% had two or more organ systems fail, according to the study.
When researchers conducted a follow-up with patients on April 10, they found that two children, or 4% of participants, had died while 15 patients, or 31%, were still hospitalized. Among the 15 patients still being treated in PICUs, five were still reported to be in critical condition, three still required ventilatory support, and one was receiving extracorporeal membrane oxygenation. According to researchers, the median length of PICU and hospital stays for discharged patients fell at five and seven days, respectively.
Still, researchers have said that, overall, the children faired better than adult COVID-19 patients, exhibiting both better hospital outcomes and better survival outcomes.
"Consistent with the few other initial reports on COVID-19 on children, our study found the clinical course of COVID-19 to be far less severe and the hospital outcomes to be better in critically ill children than those reported in adults," researchers noted. "We can be cautiously encouraged by the hospital outcomes for patients in this series, with an overall ICU mortality at the end of our follow-up period of less than 5% compared with published mortalities of 50% to 62% in adults admitted to the ICU."
Additionally, the small number of children found to have been hospitalized with COVID-19 appears to mirror the low rate of hospitalization found in figures released by the Centers for Disease Control and Prevention (CDC). A CDC report published earlier this month, concluded that "relatively few pediatric COVID-19 cases were hospitalized," citing a hospitalization rate of between 5.7% and 20%. According to the CDC, even fewer children (some 0.58% to 2%) were admitted to ICUs, or PICUs, as a result of COVID-19. That echoes an earlier CDC study, which found COVID-19-related hospitalization rates increased with age.
But while studies like this one continue to show that children may be less likely than adults to experience severe illness as a result of COVID-19, the fact is children are not completely immune to the virus. In fact, recent reports have shown that dozens of children in the United Kingdom, the United States, and Europe have exhibited symptoms of a rare and potentially deadly COVID-related illness known as pediatric multi-system inflammatory syndrome. According to The New York Times, at least three children in New York have reportedly died from the illness, meaning more research is absolutely needed to learn how the novel coronavirus can affect children.
If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all of Romper’s parents + coronavirus coverage here, and Bustle’s constantly updated, general “what to know about coronavirus” here.
Shekerdemian, L. S., Mahmood, N. R., Wolfe, K. K., Riggs, B. J., Ross, C. E., McKiernan, C. A., … Burns, J. P. (2020). Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units. JAMA Pediatrics. doi: 10.1001/jamapediatrics.2020.1948