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Risk factors for PICU admission and death among children and young people hospitalized with COVID-19 and PIMS-TS in England during the first pandemic year

Identifying which children and young people (CYP) are most vulnerable to serious infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to guide protective interventions. To address this question, we used data for all hospitalizations in England among 0-17 year ol... Full description

Journal Title: Nature medicine 2022, Vol.28 (1), p.193-200
Main Author: Ward, Joseph L
Other Authors: Harwood, Rachel , Smith, Clare , Kenny, Simon , Clark, Matthew , Davis, Peter J , Draper, Elizabeth S , Hargreaves, Dougal , Ladhani, Shamez , Linney, Michael , Luyt, Karen , Turner, Steve , Whittaker, Elizabeth , Fraser, Lorna K , Viner, Russell M
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Nature Publishing Group
ID: ISSN: 1078-8956
Link: https://www.ncbi.nlm.nih.gov/pubmed/34931076
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title: Risk factors for PICU admission and death among children and young people hospitalized with COVID-19 and PIMS-TS in England during the first pandemic year
format: Article
creator:
  • Ward, Joseph L
  • Harwood, Rachel
  • Smith, Clare
  • Kenny, Simon
  • Clark, Matthew
  • Davis, Peter J
  • Draper, Elizabeth S
  • Hargreaves, Dougal
  • Ladhani, Shamez
  • Linney, Michael
  • Luyt, Karen
  • Turner, Steve
  • Whittaker, Elizabeth
  • Fraser, Lorna K
  • Viner, Russell M
subjects:
  • Adolescent
  • Age Factors
  • Asians - statistics & numerical data
  • Blacks - statistics & numerical data
  • Cardiovascular Diseases - epidemiology
  • Child
  • Child, Preschool
  • Children
  • Comorbidity
  • Complications
  • Coronaviruses
  • COVID-19
  • COVID-19 - complications
  • COVID-19 - epidemiology
  • England - epidemiology
  • Ethnicity
  • Ethnicity - statistics & numerical data
  • Female
  • Hospitalization
  • Hospitalization - statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Inflammation
  • Influenza
  • Intensive care
  • Intensive Care Units, Pediatric - statistics & numerical data
  • Male
  • Minority & ethnic groups
  • Neoplasms - epidemiology
  • Nervous System Diseases - epidemiology
  • Odds Ratio
  • Pandemics
  • Pediatrics
  • Public health
  • Respiratory diseases
  • Respiratory Tract Diseases - epidemiology
  • Risk analysis
  • Risk Factors
  • SARS-CoV-2
  • Severe acute respiratory syndrome
  • Severe acute respiratory syndrome coronavirus 2
  • Severity of Illness Index
  • Social Deprivation
  • Systemic Inflammatory Response Syndrome - epidemiology
  • Viral diseases
  • Whites - statistics & numerical data
  • Young adults
ispartof: Nature medicine, 2022, Vol.28 (1), p.193-200
description: Identifying which children and young people (CYP) are most vulnerable to serious infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to guide protective interventions. To address this question, we used data for all hospitalizations in England among 0-17 year olds from 1 February 2019 to 31 January 2021. We examined how sociodemographic factors and comorbidities might be risk factors for pediatric intensive care unit (PICU) admission among hospitalizations due to the following causes: Coronavirus Disease 2019 (COVID-19) and pediatric inflammatory multi-system syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the first pandemic year (2020-2021); hospitalizations due to all other non-traumatic causes in 2020-2021; hospitalizations due to all non-traumatic causes in 2019-2020; and hospitalizations due to influenza in 2019-2020. Risk of PICU admission and death from COVID-19 or PIMS-TS in CYP was very low. We identified 6,338 hospitalizations with COVID-19, of which 259 were admitted to a PICU and eight CYP died. We identified 712 hospitalizations with PIMS-TS, of which 312 were admitted to a PICU and fewer than five CYP died. Hospitalizations with COVID-19 and PIMS-TS were more common among males, older CYP, those from socioeconomically deprived neighborhoods and those who were of non-White ethnicity (Black, Asian, Mixed or Other). The odds of PICU admission were increased in CYP younger than 1 month old and decreased among 15-17 year olds compared to 1-4 year olds with COVID-19; increased in older CYP and females with PIMS-TS; and increased for Black compared to White ethnicity in patients with COVID-19 and PIMS-TS. Odds of PICU admission in COVID-19 were increased for CYP with comorbidities and highest for CYP with multiple medical problems. Increases in odds of PICU admission associated with different comorbidities in COVID-19 showed a similar pattern to other causes of hospitalization examined and, thus, likely reflect background vulnerabilities. These findings identify distinct risk factors associated with PICU admission among CYP with COVID-19 or PIMS-TS that might aid treatment and prevention strategies.
language: eng
source:
identifier: ISSN: 1078-8956
fulltext: no_fulltext
issn:
  • 1078-8956
  • 1546-170X
url: Link


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titleRisk factors for PICU admission and death among children and young people hospitalized with COVID-19 and PIMS-TS in England during the first pandemic year
creatorWard, Joseph L ; Harwood, Rachel ; Smith, Clare ; Kenny, Simon ; Clark, Matthew ; Davis, Peter J ; Draper, Elizabeth S ; Hargreaves, Dougal ; Ladhani, Shamez ; Linney, Michael ; Luyt, Karen ; Turner, Steve ; Whittaker, Elizabeth ; Fraser, Lorna K ; Viner, Russell M
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descriptionIdentifying which children and young people (CYP) are most vulnerable to serious infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to guide protective interventions. To address this question, we used data for all hospitalizations in England among 0-17 year olds from 1 February 2019 to 31 January 2021. We examined how sociodemographic factors and comorbidities might be risk factors for pediatric intensive care unit (PICU) admission among hospitalizations due to the following causes: Coronavirus Disease 2019 (COVID-19) and pediatric inflammatory multi-system syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the first pandemic year (2020-2021); hospitalizations due to all other non-traumatic causes in 2020-2021; hospitalizations due to all non-traumatic causes in 2019-2020; and hospitalizations due to influenza in 2019-2020. Risk of PICU admission and death from COVID-19 or PIMS-TS in CYP was very low. We identified 6,338 hospitalizations with COVID-19, of which 259 were admitted to a PICU and eight CYP died. We identified 712 hospitalizations with PIMS-TS, of which 312 were admitted to a PICU and fewer than five CYP died. Hospitalizations with COVID-19 and PIMS-TS were more common among males, older CYP, those from socioeconomically deprived neighborhoods and those who were of non-White ethnicity (Black, Asian, Mixed or Other). The odds of PICU admission were increased in CYP younger than 1 month old and decreased among 15-17 year olds compared to 1-4 year olds with COVID-19; increased in older CYP and females with PIMS-TS; and increased for Black compared to White ethnicity in patients with COVID-19 and PIMS-TS. Odds of PICU admission in COVID-19 were increased for CYP with comorbidities and highest for CYP with multiple medical problems. Increases in odds of PICU admission associated with different comorbidities in COVID-19 showed a similar pattern to other causes of hospitalization examined and, thus, likely reflect background vulnerabilities. These findings identify distinct risk factors associated with PICU admission among CYP with COVID-19 or PIMS-TS that might aid treatment and prevention strategies.
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descriptionIdentifying which children and young people (CYP) are most vulnerable to serious infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to guide protective interventions. To address this question, we used data for all hospitalizations in England among 0-17 year olds from 1 February 2019 to 31 January 2021. We examined how sociodemographic factors and comorbidities might be risk factors for pediatric intensive care unit (PICU) admission among hospitalizations due to the following causes: Coronavirus Disease 2019 (COVID-19) and pediatric inflammatory multi-system syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the first pandemic year (2020-2021); hospitalizations due to all other non-traumatic causes in 2020-2021; hospitalizations due to all non-traumatic causes in 2019-2020; and hospitalizations due to influenza in 2019-2020. Risk of PICU admission and death from COVID-19 or PIMS-TS in CYP was very low. We identified 6,338 hospitalizations with COVID-19, of which 259 were admitted to a PICU and eight CYP died. We identified 712 hospitalizations with PIMS-TS, of which 312 were admitted to a PICU and fewer than five CYP died. Hospitalizations with COVID-19 and PIMS-TS were more common among males, older CYP, those from socioeconomically deprived neighborhoods and those who were of non-White ethnicity (Black, Asian, Mixed or Other). The odds of PICU admission were increased in CYP younger than 1 month old and decreased among 15-17 year olds compared to 1-4 year olds with COVID-19; increased in older CYP and females with PIMS-TS; and increased for Black compared to White ethnicity in patients with COVID-19 and PIMS-TS. Odds of PICU admission in COVID-19 were increased for CYP with comorbidities and highest for CYP with multiple medical problems. Increases in odds of PICU admission associated with different comorbidities in COVID-19 showed a similar pattern to other causes of hospitalization examined and, thus, likely reflect background vulnerabilities. These findings identify distinct risk factors associated with PICU admission among CYP with COVID-19 or PIMS-TS that might aid treatment and prevention strategies.
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9Complications
10Coronaviruses
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12COVID-19 - complications
13COVID-19 - epidemiology
14England - epidemiology
15Ethnicity
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17Female
18Hospitalization
19Hospitalization - statistics & numerical data
20Humans
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22Infant, Newborn
23Inflammation
24Influenza
25Intensive care
26Intensive Care Units, Pediatric - statistics & numerical data
27Male
28Minority & ethnic groups
29Neoplasms - epidemiology
30Nervous System Diseases - epidemiology
31Odds Ratio
32Pandemics
33Pediatrics
34Public health
35Respiratory diseases
36Respiratory Tract Diseases - epidemiology
37Risk analysis
38Risk Factors
39SARS-CoV-2
40Severe acute respiratory syndrome
41Severe acute respiratory syndrome coronavirus 2
42Severity of Illness Index
43Social Deprivation
44Systemic Inflammatory Response Syndrome - epidemiology
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46Whites - statistics & numerical data
47Young adults
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titleRisk factors for PICU admission and death among children and young people hospitalized with COVID-19 and PIMS-TS in England during the first pandemic year
authorWard, Joseph L ; Harwood, Rachel ; Smith, Clare ; Kenny, Simon ; Clark, Matthew ; Davis, Peter J ; Draper, Elizabeth S ; Hargreaves, Dougal ; Ladhani, Shamez ; Linney, Michael ; Luyt, Karen ; Turner, Steve ; Whittaker, Elizabeth ; Fraser, Lorna K ; Viner, Russell M
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3Blacks - statistics & numerical data
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abstractIdentifying which children and young people (CYP) are most vulnerable to serious infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to guide protective interventions. To address this question, we used data for all hospitalizations in England among 0-17 year olds from 1 February 2019 to 31 January 2021. We examined how sociodemographic factors and comorbidities might be risk factors for pediatric intensive care unit (PICU) admission among hospitalizations due to the following causes: Coronavirus Disease 2019 (COVID-19) and pediatric inflammatory multi-system syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the first pandemic year (2020-2021); hospitalizations due to all other non-traumatic causes in 2020-2021; hospitalizations due to all non-traumatic causes in 2019-2020; and hospitalizations due to influenza in 2019-2020. Risk of PICU admission and death from COVID-19 or PIMS-TS in CYP was very low. We identified 6,338 hospitalizations with COVID-19, of which 259 were admitted to a PICU and eight CYP died. We identified 712 hospitalizations with PIMS-TS, of which 312 were admitted to a PICU and fewer than five CYP died. Hospitalizations with COVID-19 and PIMS-TS were more common among males, older CYP, those from socioeconomically deprived neighborhoods and those who were of non-White ethnicity (Black, Asian, Mixed or Other). The odds of PICU admission were increased in CYP younger than 1 month old and decreased among 15-17 year olds compared to 1-4 year olds with COVID-19; increased in older CYP and females with PIMS-TS; and increased for Black compared to White ethnicity in patients with COVID-19 and PIMS-TS. Odds of PICU admission in COVID-19 were increased for CYP with comorbidities and highest for CYP with multiple medical problems. Increases in odds of PICU admission associated with different comorbidities in COVID-19 showed a similar pattern to other causes of hospitalization examined and, thus, likely reflect background vulnerabilities. These findings identify distinct risk factors associated with PICU admission among CYP with COVID-19 or PIMS-TS that might aid treatment and prevention strategies.
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