"For COVID" or "With COVID": Classification of SARS-CoV-2 Hospitalizations in Children.

Autor:	Kushner LE; Divisions of Infectious Diseases., Schroeder AR; Pediatric Critical Care.; Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California., Kim J; Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California., Mathew R; Divisions of Infectious Diseases roshnim@stanford.edu.
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2021 Aug; Vol. 11 (8), pp. e151-e156. Date of Electronic Publication: 2021 May 19.
DOI:	10.1542/hpeds.2021-006001
Abstrakt:	Objectives: Pediatric hospitalization rates are used as a marker of coronavirus disease 2019 (COVID-19) disease severity in children but may be inflated by the detection of mild or asymptomatic infection via universal screening. We aimed to classify COVID-19 hospitalizations using an existing and novel approach and to assess the interrater reliability of both approaches. Methods: This retrospective cohort study characterized severity of illness and likelihood of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as the cause of hospitalization in pediatric patients <18 years of age. Subjects had positive SARS-CoV-2 nasopharyngeal testing or were diagnosed with multisystem inflammatory syndrome in children and were hospitalized between May 10, 2020 (when universal screening of all admissions began) and February 10, 2021, at a university-based, quaternary care children's hospital in Northern California. Hospitalizations were categorized as either likely or unlikely to be caused by SARS-CoV-2 (novel approach), and disease severity was categorized according to previously published classification of disease severity. Results: Of 117 hospitalizations, 46 (39.3%) were asymptomatic, 33 (28.2%) had mild to moderate disease, 9 (7.7%) had severe illness, and 15 (12.8%) had critical illness (weighted κ: 0.82). A total of 14 (12%) patients had multisystem inflammatory syndrome in children. A total of 53 (45%) admissions were categorized as unlikely to be caused by SARS-CoV-2 (κ: 0.78). Conclusions: Although COVID-19 has considerable associated morbidity and mortality in children, reported hospitalization rates likely lead to overestimation of the true disease burden. Competing Interests: POTENTIAL CONFLICTS OF INTEREST: Dr Schroeder is an Associate Editor at Hospital Pediatrics. (Copyright © 2021 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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