期刊
PEDIATRICS
卷 148, 期 3, 页码 -出版社
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2020-042929
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资金
- Innovative Medicines Initiative 2 Joint Undertaking [806968]
- European Union's Horizon 2020 research and innovation programme
- European Federation of Pharmaceutical Industries and Associations (EFPIA)
- National Institute for Health Research Oxford Biomedical Research Centre
- US National Institutes of Health
- US Department of Veterans Affairs
- Janssen Research Development
- IQVIA
- Bill & Melinda Gates Foundation [INV-016201, INV-019257]
- health department from the Generalitat de Catalunya
- National Institute for Health Research Academy
- Aziz Foundation
- Wolfson Foundation
- Royal College of Surgeons of England
- Wellcome Trust Clinical Research Career Development Fellowship [214588/Z/18/Z]
- Wellcome Trust [214588/Z/18/Z] Funding Source: Wellcome Trust
- Bill and Melinda Gates Foundation [INV-016201, INV-019257] Funding Source: Bill and Melinda Gates Foundation
This study characterized the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes of children and adolescents diagnosed or hospitalized with COVID-19 compared to patients diagnosed with influenza, finding that COVID-19 patients had more complications despite negligible fatality.
OBJECTIVES: To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children and adolescents diagnosed or hospitalized with coronavirus disease 2019 (COVID-19) and to compare them in secondary analyses with patients diagnosed with previous seasonal influenza in 2017-2018. METHODS: International network cohort using real-world data from European primary care records (France, Germany, and Spain), South Korean claims and US claims, and hospital databases. We included children and adolescents diagnosed and/or hospitalized with COVID-19 at age <18 between January and June 2020. We described baseline demographics, comorbidities, symptoms, 30-day in-hospital treatments, and outcomes including hospitalization, pneumonia, acute respiratory distress syndrome, multisystem inflammatory syndrome in children, and death. RESULTS: A total of 242 158 children and adolescents diagnosed and 9769 hospitalized with COVID-19 and 2 084 180 diagnosed with influenza were studied. Comorbidities including neurodevelopmental disorders, heart disease, and cancer were more common among those hospitalized with versus diagnosed with COVID-19. Dyspnea, bronchiolitis, anosmia, and gastrointestinal symptoms were more common in COVID-19 than influenza. In-hospital prevalent treatments for COVID-19 included repurposed medications (<10%) and adjunctive therapies: systemic corticosteroids (6.8%-7.6%), famotidine (9.0%-28.1%), and antithrombotics such as aspirin (2.0%-21.4%), heparin (2.2%-18.1%), and enoxaparin (2.8%-14.8%). Hospitalization was observed in 0.3% to 1.3% of the cohort diagnosed with COVID-19, with undetectable (n < 5 per database) 30-day fatality. Thirty-day outcomes including pneumonia and hypoxemia were more frequent in COVID-19 than influenza. CONCLUSIONS: Despite negligible fatality, complications including hospitalization, hypoxemia, and pneumonia were more frequent in children and adolescents with COVID-19 than with influenza. Dyspnea, anosmia, and gastrointestinal symptoms could help differentiate diagnoses. A wide range of medications was used for the inpatient management of pediatric COVID-19.
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