27 Sep More Than Half of Children Admitted for COVID-19 in Early Pandemic Had No Co-Morbidities
MedicalResearch.com Interview with:
Shaun K. Morris MD, MPH, FRCPC, FAAP, DTM&H
Divisions of General Pediatrics
Clinician-Scientist, Division of Infectious Diseases
Division of Infectious Diseases at the Hospital for Sick Children (SickKids)
for the Canadian Paediatric Surveillance Program COVID-19 Study Team
MedicalResearch.com: What is the background for this study?
Response: The SARS-CoV-2 virus can cause the disease we now call COVID-19. In early 2020, when the SARS-CoV-2 virus first spread outside of China, it quickly became apparent that cases may be seen in Canada. It was not known at the time how infection with the virus would affect children and youth. Because more severe disease from other respiratory viruses often disproportionally affect the very young, we expected that a similar pattern may be seen with SARS-CoV-2. We also did not know if children and youth with certain underlying medical conditions may be at higher risk for more severe disease.
Ultimately, this study was designed to get a better understanding of how often children and youth in Canada are hospitalized with SARS-CoV-2 infection, how often severe disease happens, and which children or youth may be at higher risk for severe disease.
MedicalResearch.com: What are the main findings?
Response: The data in this study were collected from the beginning of the pandemic in late March 2020 to the end of December 2020, which is before the emergence of the variants of concern, including Delta. Our first main finding of the study is that hospitalization of children and youth with SARS-CoV-2 infection during this first part of the pandemic was fortunately rare.
Another important finding was that a significant proportion, almost 40%, of children and youth who were admitted to hospital with SARS-CoV-2 infection were admitted for completely different reasons. These were often patients without symptoms who were admitted for a surgical procedure or another medical reason but they tested positive for SARS-CoV-2 infection on a screening test. Of the children and youth admitted to hospital primarily for treatment of COVID-19, the age group most likely to have severe disease was not the very young but rather adolescents. We did find that several underlying medical conditions were more common in those with severe disease including obesity, chronic neurologic conditions, and chronic lung conditions other than asthma.
MedicalResearch.com: What should readers take away from your report?
Response: While COVID-19 has had profound direct and indirect impacts on the lives of many children, youth and their families, hospitalization of children and youth because of COVID-19 was low in the first part of the pandemic. Although these hospitalization rates were low, it is important to note that among children and youth hospitalized for COVID-19, 60% did not have any underlying co-morbidity. Severe disease did sometimes occur but it was more common in adolescents and in those with certain types of underlying medical conditions. The results must be interpreted in the context that this study was conducted before the Delta variant became the most common variant of the SARS-CoV-2 virus in Canada.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: There are multiple important areas of future research regarding the paediatric population and COVID-19. These include gaining a better understanding of if and how variants of concern may be different from earlier versions of the virus in terms of disease severity in children and youth and how common longer term sequalae of infection may be. Furthermore, although the COVID-19 vaccines approved for youth to date have been shown to be safe and effective in clinical trials, it will be important to monitor the ongoing impact that vaccination will have on the risk and severity of SARS-CoV-2 infection in this age group
Disclosures of all authors are listed in the paper.
Characteristics of children admitted to hospital with acute SARS-CoV-2 infection in Canada in 2020
Olivier Drouin, Charlotte Moore Hepburn, Daniel S. Farrar, Krista Baerg, Kevin Chan, Claude Cyr, Elizabeth J. Donner, Joanne E. Embree, Catherine Farrell, Sarah Forgie, Ryan Giroux, Kristopher T. Kang, Melanie King, Melanie Laffin, Thuy Mai Luu, Julia Orkin, Jesse Papenburg, Catherine M. Pound, Victoria E. Price, Rupeena Purewal, Manish Sadarangani, Marina I. Salvadori, Karina A. Top, Isabelle Viel-Thériault, Fatima Kakkar and Shaun K. Morris; for the Canadian Paediatric Surveillance Program COVID-19 Study Team
CMAJ September 27, 2021 193 (38) E1483-E1493; DOI: https://doi.org/10.1503/cmaj.210053
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