Journal
CANADIAN MEDICAL ASSOCIATION JOURNAL
Volume 193, Issue 38, Pages E1483-E1493Publisher
CMA-CANADIAN MEDICAL ASSOC
DOI: 10.1503/cmaj.210053
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Funding
- Ontario Brain Institute
- Health Canada
- Fonds de recherche du Quebec -Sante
- Pfizer Canada
- MedImmune
- Sanofi Pasteur
- AbbVie
- GlaxoSmithKline
- Merck
- Pfizer
- VBI Vaccines
- BC Children's Hospital Foundation
- Canadian Child Health Clinician Scientist Program
- Michael Smith Foundation for Health Research
- Public Health Agency of Canada (Morris)
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Risk factors for severe outcomes of SARS-CoV-2 infection in children in Canada were investigated, with obesity, chronic neurologic conditions, and chronic lung disease identified as major factors associated with more severe COVID-19. Infants and adolescents were found to be at higher risk of hospital admissions related to COVID-19 during the early pandemic period.
Background: Risk factors for severe outcomes of SARS-CoV-2 infection are not well established in children. We sought to describe pediatric hospital admissions associated with SARS-CoV-2 infection in Canada and identify risk factors for more severe disease. Methods: We conducted a national prospective study using the infrastructure of the Canadian Paediatric Surveillance Program (CPSP). Cases involving children who were admitted to hospital with microbiologically confirmed SARS-CoV-2 infection were reported from Apr. 8 to Dec. 31 2020, through weekly online questionnaires distributed to the CPSP network of more than 2800 pediatricians. We categorized hospital admissions as related to COVID-19, incidental, or for social or infection control reasons and determined risk factors for disease severity in hospital. Results: Among 264 hospital admissions involving children with SARS-CoV-2 infection during the 9-month study period, 150 (56.8%) admissions were related to COVID-19 and 100 (37.9%) were incidental infections (admissions for other reasons and found to be positive for SARS-CoV-2 on screening). Infants (37.3%) and adolescents (29.6%) represented most cases. Among hospital admissions related to COVID-19, 52 (34.7%) had critical disease, 42 (28.0%) of whom required any form of respiratory or hemodynamic support, and 59 (39.3%) had at least 1 underlying comorbidity. Children with obesity, chronic neurologic conditions or chronic lung disease other than asthma were more likely to have severe or critical COVID-19. Interpretation: Among children who were admitted to hospital with SARS-CoV-2 infection in Canada during the early COVID-19 pandemic period, incidental SARS-CoV-2 infection was common. In children admitted with acute COVID-19, obesity and neurologic and respiratory comorbidities were associated with more severe disease.
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