Epidemiology of 7375 children and adolescents hospitalized with COVID-19 in Germany, reported via a prospective, nationwide surveillance study in 2020–2022
Authors: Doenhardt Maren , Hufnagel Markus , Diffloth Natalie , Hübner Johannes , Mauer René , Schneider Dominik T. , Simon Arne , Tenenbaum Tobias , Trotter Andreas , Armann Jakob , Berner Reinhard ,   The DGPI COVID-19 working group, Abuleed Aischa , Achenbach Michal , Adamiak-Brych Grazyna , Aderhold Martina , Akanbi Sandra , Akmeinasi Madaa , Albers Norbert , Ammann-Schnell Louisa , Anders Kristin , Andree Theresa , Anhalt Judith , Apel Nils , Arens Stefan , Aring Christoph , Armbruster Caroline , Arnold Inken , Austgen Thomas , Bachmat Igor , Balles Lena , Baltaci Arne , Baranowski Theresa , Barth Sylvia , Barth Stefan , Castrillón María Paula Bateman , Baumann Susanne , Baumbach Lisa , Becker Boris , Beer Angelina , Beier Gerald , Bell Christiane , Bellou Antigoni , Bentz Stephanie , Berens Josephine , Berger Elisabeth , Berzel Simon , Bley Julia , Blumberg Helga , Blume Stefanie , Böckenholt Kai , Böckmann Andreas , Bode Sebastian , Boever Julie , Böhm Leonie , Böhme Henning , Bölke Carsten , Borchers Monika-Maria , Bosse Hans Martin , Böswald Michael , Botschen Katharina , Böttger Franka , Braun Sandra , Brenner Britta , Brinkmann Folke , Bruggmoser Beate , Brunner Jürgen , Bucher Florian L. , Buchtala Laura , Budde Jörg , Bullmann Reinhard , Bungert Bernhard , Büsdorf Dorothea , Cardellini Lisa , Cattaneo Chiara , Chao Cho-Ming , Chaparro Laura , Christians Claus , Cremer Kerstin , Cvetanovic Gordana , Czwienzek Alina , Daluwatta Madura , de Sousa Gideon , Degirmenci Metin , Dejas Fenja , Deutschmann Janne , Deutz Ute , Dobrianska Iryna , Döhring Katharina , Donath Helena , Dresen Arne , Dreßen Svenja , Drozdek Melissa , Dubenhorst Jens , Dunker Max , Eberhardt Heinrich , Ebert Franziska , Echelmeyer Hannah , Ehrentraut Kerstin , Ehrsam Christoph , Eichelmann Thea Angelika , Ellmann Hanna , Endmann Matthias , Endres Stefanie , Endres Elisa , Engler Matthias , Engler Denise , Eppler David , Erbe Oxana , Erdmann Michael , Esser Annika , Ewest Stephan , Falderbaum Philipp , Faßbender Lena , Ferber Simone , Fiedler Andreas , Fischer Magdalena , Fischer Doris , Fischer-Ging Elisabeth , Fischer-Schmidt Isabel , Fleischer Ann-Sophie , Flümann Simon , Focke Denise , Foth Svenja , Fövényesi Réka , Frank Svenja , Fremerey Christian , Frenzke Holger , Freudenberg Peter , Freudenhammer Mirjam , Fritsch Christina , Frohn Stefanie , Fuhrmann Sylvia , Pavlíková Veronika Galajda , Galow Lukas , Gappa Monika , Gärtner Sabine , Gaspar Hanga , Geerken Swen , Gehm Julia , Gehrlein Fabienne , Geier Norbert , Geißlreiter Bernd , Geltinger Martin , Gerlach Marieke , Gerleve Hubert , Germann Carl , Giesen Verena , Girrbach Anna , Glas Katharina , Goetz Lena , Goj Karoline , Goldhardt Christin , Gottschalk Julia , Gottschlich Jan-Felix , Götz Oliver , Gröger Katrin , Gronwald Sina , Lordemann Anja Große , Grotheer Anneke , Gruber Kathrin , Grüner Judith , Grünwedel Mike , Gu Lisa , Gummersbach Joya , Haag Stephan , Haag Silke , Hagel Yasmin , Hagemann Swantje , Hainmann Ina , Halwas Nikolaus , Hanke Christof , Härtner Jonas , Haselier Caroline , Haupt Anne , Heffels Marie- Kristin , Heidtmann Solvej , Heimer Anna-Lena , Heinrich Christina , Heinrich Annika , Hempel Lutz , Hempel Christoph , Hennig Silke , Herbst Carolin , Herholz Leonie , Hermann Matthias , Hermens Jan-Simon , Hertel Marc , Herzog Matthias , Heubner Georg , Hildebrandt Julia , Hilker Kai-Alexandra , Hillebrand Georg , Himpel Matthias , Hirschhausen Claudia , Höfer Meike , Hoffmann Liane , Hoffmann Hans-Georg , Höfgen Mirjam , Hofknecht Nina , Hofmann Anja , Hofmann Franziska , Holtkamp Katharina , Holzinger Mona , Homburg Anneke , Hoppen Thomas , Horst Theresa , Horváth Andor Attila , Hummler Markus , Hundsdörfer Patrick , Hüseman Dieter , Huster Conny , Ido Nora , Ioannou Phryne , Jedwilayties Simone , Jonas Nils , Junge Cornelia , Junghanns Linda , Kádár Attila , Kaddour Mohammad , Kahlenberg Lea , Kaiser Lukas , Kaiser-Labusch Petra , Kalhoff Hermann , Kaltenhauser Carola , Kaluza Elke , Kamin Wolfgang , Kanann Cecil Varna , Kania Marcus , Kannan Cecil Varna , Kanneettukandathil Subha , Karpinski Hendrik , Kassbeger Fabian , Kauertz Katja , Kavvalou Alexandra , Kelzon Svetlana , Kern Immo , Kernen Elisabeth , Kersten Mandy , Keßner Marie-Sophie , Kever Daniel , Khakzar Carolin , Kim Johanna , Kirner Linda , Kirschstein Martin , Kiss Natalie , Kitz Richard , Kleff Christine , Klein Deborah , Klingel Leah Bernadette , Kluthe Christof , Knechtel Jan , Kneißle Marcel , Knirsch Felix , Kobbe Robin , Köbsch Annemarie , Kohlen Luisa , Kohlhauser-Vollmuth Christina , Vasconcelos Malte Kohns , Königs Anne , Konrad Florian , Koop Sabrina , Kopka Julia , Kornherr Vanessa , Kortenbusch Anna-Lena , Kosteczka Robert , Köster Holger , Kowski Sascha , Kravets Hanna , Krink Ewa , Krogh Maren , Kuglin Rebecca , Kühl Reinhard , Kuhlmann Alena , Küpper-Tetzel Lea Maria , Kuska Marion , Kwaschnowitz Sachiko , Lange Martina , Lankes Franziska , Laubenbacher Julia , Lautner Gerrit , Le Thanh Tung , Leykamm Verena , Libuschewski Hanna , Lichtenstein Lissy , Lienert Nadine , Liese Johannes , Lieser Ulla , Lindl Ilona , Lindner Torben , Lischetzki Grischa , Lohr Matthias , Lorenz Norbert , Lorenzen Niko , Löwe Meike , Lubitz Daniela , Lueg Maria , Luft Lisa , Luo Sa , Lwowsky Dominik , Machon Kathrin , Magin Katharina , Maiberger Thomas , Mand Nadine , Markowsky Andrea , Maurer Wiebke , Mauritz Maximilian , Meinhold Theresa , Meister Jochen , Menden Melanie , Messer Veronika , Meyburg Jochen , Meyer Ulf , Meyer Meike , Meyer Jens , Meyer-Dobkowitz Lars , Michel Peter , Mohorovicic Marko , Moise Laura Gabriela , Mönch Katharina , Monnheimer Mathieu , Morawski Yvonne , Morgenbrod Anja , Moritz Katrin , Muhmann David , Müksch Barbara , Müller Stefanie , Müller Celina , Müller Annemarie , Müller Viola , Müller Yvonne , Müller Guido , Müller-Franz Kathleen , Naehrlich Lutz , Naghed Katharina , Näther Nicole , Nespor Tereza , Neuhierl Tatjana , Neukamm Ann-Cathrine , Nguyen Nam , Nielsen Dirk , Niethammer Klaus , Obernosterer Lydia , Opgen-Rhein Bernd , Östreicher Iris , Özdemir Esra , Paduraru-Stoian Nadejda , Palm Monique , Parigger Laura , Pellmann Nina , Pelster Theresa , Pengu Ardina , Pentek Falk , Petrasch Maurice , Pfennigs Antonia Maximina , Pfisterer Aaron , Pfülb Anne , Piehler Lisa , Pindur Ursula , Pingel Markus , Pitsikoulis Eva , Plutowski Jana , Poot Wendy , Poralla Silvia , Pottiez Johanna , Pötzsch Simone , Pretzel Pablo , Preuß Clarissa , Propson Sven , Puhachova Kateryna , Pütz Daniela , Quadri-Niazi Samina , Queisser Bernhard , Rambow Jennifer , Rau Gunnar , Rau Cornelius , Raum Jacqueline , Reck Heike , Rehmann Victoria , Reichert Friedrich , Reinhardt Thomas , Remy Carla , Renk Hanna , Richard Annika , Richter Carolin , Rieber Nikolaus , Riedhammer Sebastian , Ringe Hannelore , Rippberger Bianca , Rohrbach Moritz , Rokonal Bettina , Rötger Caroline , Rothermel Anne , Rox Ricarda , Rühlmann Alexander , Ryckmanns Marie-Cecile , Safarova Shahane , Salem Meila , Sarial Demet , Sartor Helena , Saxe Johanna , Schade Herbert , Schäfer Miriam , Scheffler Cecilia , Scheffler Lena Brigitte , Scheiermann Marija , Schiele Sandra , Schierloh Katja , Schiller Markus , Schiller Benjamin , Schilling Ruth , Schitke Christof , Schlabach Christian , Schlichting Theresa , Schlick Christian , Schlingschröder Christina , Schmid Florian , Schmidt Bastian , Schneider Josephine , Schneider Dominik , Schneider Hans-Christoph , Schnelke Alexander , Schobeß Axel , Schrod Lothar , Schröder Arne , Schröder Sophia , Schug Theresia , Schulze Christopher , Schuster Katharina , Schütz Katharina , Schwägerl Valeria , Seidel Christoffer , Seidel Christina , Seidel Sabrina , Seidel Josephin , Seringhaus-Förster Katrin , Setzer Armin , Seul Ralf , Shabanah Wael , Shamdeen M. Ghiath , Sigl Sebastian , Simon Isabel , Solomou Christina , Sönmez Ezgi , Spath Lisa , Spehl Marco , Stanjek Thomas , Staude Daniel , Steenblock Janina , Stehle Sandro , Steidl Michael , Steif Benedikt , Stein Detlef , Stein Franziska , Steindor Mathis , Stemberg Frank , Stephan Susanne , Stienen Astrid , Stockmann Antje , Strier Ursula , Ströle Heidi , Szudarek Roman , Ta Van Hop , Tan Kader , Telaar Rebecca , Telschow Anna , Teufel Lisa , Thein Stephanie , Thiel Lion Gabriel , Thiesing Lisa , Thomas Linda , Thomas Julian , Timke Christian , Toni Irmgard , Topuz Melcan , Trau Stefanie , Tschiedel Eva , Tzimou Sinty , Uhlemann Felix , Uhlig Torsten , Ulla Lieser , Urgatz Bartholomäus , Salis Nicolaus v. , Soldenhoff Sascha v. , van Bahlen Louisa , van den Heuvel Alijda Ingeborg , Vehse Kai , Veit Rebecca , Verleysdonk Joshua , Viechtbauer Andreas , Vieth Simon , Vogel Markus , von Blomberg Sophia , von der Decken Kira , von Schnakenburg Christian , Wagner Julia , Wahjudi Tatjana , Waldecker Karin , Walden Ulrike , Walther Ulrike , Walther Mona , Wegendt Christine , Wehl Götz , Weichert Stefan , Weiland Judith Anne , Weiß Julia , Wendt Laura , Wentzel Vera , Wersal Cornelia , Wetzel Ulrike , Wichmann Barbara , Wickert Katharina , Wieland Sandra , Wiethoff Christiane Maria , Wietz Hanna , Wild Florian , Willing Rainer , Windischmann Christian , Winkeler Verena , Winkelmann Merle , Winkler Sascha , Wißlicen Laura , Wormit-Frenzel Isabel , Wowra Tobias , Wroblewski Andreas , Wulf Dominik , Wurm Donald , Zaddach Malin , Zahn Julia , Zbieranek Kai , Zehnder Lara-Sophie , Zeller Anne , Zellerhoff Martin , Zerlik Katharina , Zimmermann Johanna , Zimolová Mária , Zügge Ulrich 
Published: January 2024

By means of a nationwide, prospective, multicenter, observational cohort registry collecting data on 7375 patients with laboratory-confirmed SARS-CoV-2 admitted to children's hospitals in Germany, March 2020–November 2022, our study assessed the clinical features of children and adolescents hospitalized due to SARS-CoV-2, evaluated which of these patients might be at highest risk for severe COVID-19, and identified underlying risk factors. Outcomes tracked included: symptomatic infection, case fatality, sequelae at discharge and severe disease. Among reported cases, median age was one year, with 42% being infants. Half were admitted for reasons other than SARS-CoV-2. In 27%, preexisting comorbidities were present, most frequently obesity, neurological/neuromuscular disorders, premature birth, and respiratory, cardiovascular or gastrointestinal diseases. 3.0% of cases were admitted to ICU, but ICU admission rates varied as different SARS-CoV-2 variants gained prevalence. Main risk factors linked to ICU admission due to COVID-19 were: patient age (> 12 and 1–4 years old), obesity, neurological/neuromuscular diseases, Trisomy 21 or other genetic syndromes, and coinfections at time of hospitalization. With Omicron, the group at highest risk shifted to 1–4-year-olds. For both health care providers and the general public, understanding risk factors for severe disease is critical to informing decisions about risk-reduction measures, including vaccination and masking guidelines.