Characterization and Outcomes of Hospitalized Children With Coronavirus Disease 2019: A Report From a Multicenter, Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) Registry
Authors: Bhalala Utpal S. , Gist Katja M. , Tripathi Sandeep , Boman Karen , Kumar Vishakha K. , Retford Lynn , Chiotos Kathleen , Blatz Allison M. , Dapul Heda , Verma Sourabh , Sayed Imran A. , Gharpure Varsha P. , Bjornstad Erica , Tofil Nancy , Irby Katherine , Sanders Ronald C. , Heneghan Julia A. , Thomas Melissa , Gupta Manoj K. , Oulds Franscene E. , Arteaga Grace M. , Levy Emily R. , Gupta Neha , Kaufman Margit , Abdelaty Amr , Shlomovich Mark , Medar Shivanand S. , Iqbal O’Meara A. M. , Kuehne Joshua , Menon Shina , Khandhar Paras B. , Miller Aaron S. , Barry Suzanne M. , Danesh Valerie C. , Khanna Ashish K. , Zammit Kimberly , Stulce Casey , McGonagill Patrick W. , Bercow Asher , Amzuta Ioana G. , Gupta Sandeep , Almazyad Mohammed A. , Pierre Louisdon , Sendi Prithvi , Ishaque Sidra , Anderson Harry L. , Nawathe Pooja , Akhter Murtaza , Lyons Patrick G. , Chen Catherine , Walkey Allan J. , Bihorac Azra , Wada Bello Imam , Ben Ari Judith , Kovacevic Tanja , Bansal Vikas , Brinton John T. , Zimmerman Jerry J. , Kashyap Rahul ,   for The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
Published: August 2021

Objectives:
Multicenter data on the characteristics and outcomes of children hospitalized with coronavirus disease 2019 are limited. Our objective was to describe the characteristics, ICU admissions, and outcomes among children hospitalized with coronavirus disease 2019 using Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 registry.

Design:
Retrospective study.

Setting:
Society of Critical Care Medicine Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) registry.

Patients:
Children (< 18 yr) hospitalized with coronavirus disease 2019 at participating hospitals from February 2020 to January 2021.

Interventions:
None.

Measurements and Main Results:
The primary outcome was ICU admission. Secondary outcomes included hospital and ICU duration of stay and ICU, hospital, and 28-day mortality. A total of 874 children with coronavirus disease 2019 were reported to Viral Infection and Respiratory Illness Universal Study registry from 51 participating centers, majority in the United States. Median age was 8 years (interquartile range, 1.25–14 yr) with a male:female ratio of 1:2. A majority were non-Hispanic (492/874; 62.9%). Median body mass index (n = 817) was 19.4 kg/m2 (16–25.8 kg/m2), with 110 (13.4%) overweight and 300 (36.6%) obese. A majority (67%) presented with fever, and 43.2% had comorbidities. A total of 238 of 838 (28.2%) met the Centers for Disease Control and Prevention criteria for multisystem inflammatory syndrome in children, and 404 of 874 (46.2%) were admitted to the ICU. In multivariate logistic regression, age, fever, multisystem inflammatory syndrome in children, and pre-existing seizure disorder were independently associated with a greater odds of ICU admission. Hospital mortality was 16 of 874 (1.8%). Median (interquartile range) duration of ICU (n = 379) and hospital (n = 857) stay were 3.9 days (2–7.7 d) and 4 days (1.9–7.5 d), respectively. For patients with 28-day data, survival was 679 of 787, 86.3% with 13.4% lost to follow-up, and 0.3% deceased.

Conclusions:
In this observational, multicenter registry of children with coronavirus disease 2019, ICU admission was common. Older age, fever, multisystem inflammatory syndrome in children, and seizure disorder were independently associated with ICU admission, and mortality was lower among children than mortality reported in adults.