Clinical Features and Outcomes of Pediatric and Adult Patients Hospitalized for Coronavirus Disease 2019: A Comparison Across Age Strata.

Autor: Li GX; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA., Gopchandani K; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA., Brazer N; Department of Laboratory Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA.; Department of Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA., Tippett A; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA., Choi C; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA., Hsiao HM; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA., Oseguera M; Department of Laboratory Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA.; Department of Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA., Foresythe A; Department of Laboratory Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA.; Department of Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA., Bhattacharya S; Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA., Servellita V; Department of Laboratory Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA.; Department of Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA., Sotomayor Gonzalez A; Department of Laboratory Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA.; Department of Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA., Spinler JK; Department of Pathology, Texas Children's Hospital, Houston, TX, USA.; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA., Gonzalez MD; Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA, USA., Gulick D; Georgia Clinical & Translational Science Alliance, Emory University School of Medicine, Atlanta, GA, USA., Kraft C; Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA., Kasinathan V; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA., Wang YFW; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.; Clinical Microbiology Laboratory, Grady Memorial Health Center, Atlanta, GA, USA., Dien Bard J; Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Chen PY; Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Flores-Vazquez J; Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Odom John AR; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Planet PJ; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Devaraj S; Department of Pathology, Texas Children's Hospital, Houston, TX, USA.; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA., Annapragada AV; Department of Radiology, Baylor College of Medicine, Houston, TX, USA.; Department of Radiology, Texas Children's Hospital, Houston, TX, USA., Luna RA; Department of Pathology, Texas Children's Hospital, Houston, TX, USA.; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA., Chiu CY; Department of Laboratory Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA.; Department of Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA, USA., Rostad CA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.; Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Aug 10; Vol. 11 (8), pp. ofae443. Date of Electronic Publication: 2024 Aug 10 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae443
Abstrakt: Background: Coronavirus disease 2019 (COVID-19) continues to cause hospitalizations and severe disease in children and adults.
Methods: This study compared the risk factors, symptoms, and outcomes of children and adults hospitalized for COVID-19 from March 2020 to May 2023 across age strata at 5 US sites participating in the Predicting Viral-Associated Inflammatory Disease Severity in Children with Laboratory Diagnostics and Artificial Intelligence consortium. Eligible patients had an upper respiratory swab that tested positive for severe acute respiratory syndrome coronavirus 2 by nucleic acid amplification. Adjusted odds ratios (aOR) of clinical outcomes were determined for children versus adults, for pediatric age strata compared to adolescents (12-17 years), and for adult age strata compared to young adults (22-49 years).
Results: Of 9101 patients in the Predicting Viral-Associated Inflammatory Disease Severity in Children with Laboratory Diagnostics and Artificial Intelligence cohort, 1560 were hospitalized for COVID-19 as the primary reason. Compared to adults (22-105 years, n = 675), children (0-21 years, n = 885) were less commonly vaccinated (14.3% vs 34.5%), more commonly infected with the Omicron variant (49.5% vs 26.1%) and had fewer comorbidities ( P < .001 for most comparisons), except for lung disease ( P = .24). After adjusting for confounding variables, children had significantly lower odds of receiving supplemental oxygen (aOR, 0.57; 95% confidence interval, .35-.92) and death (aOR, 0.011; 95% confidence interval, <.01-.58) compa--red to adults. Among pediatric age strata, adolescents 12-17 years had the highest odds of receiving supplemental oxygen, high-flow oxygen, and ICU admission. Among adults, those 50-64 years had the highest odds of mechanical ventilation and ICU admission.
Conclusions: Clinical outcomes of COVID-19 differed across pediatric and adult age strata. Adolescents experienced the most severe disease among children, whereas adults 50-64 years experienced the most severe disease among adults.
Competing Interests: Potential conflicts of interest. C. A. R.'s institution has received funds to conduct clinical research unrelated to this manuscript from the Centers for Disease Control and Prevention, BioFire Inc, GSK, MedImmune, Janssen, Merck, Moderna, Novavax, PaxVax, Pfizer, Regeneron, Sanofi-Pasteur. She is co-inventor of patented RSV vaccine technology, which has been licensed to Meissa Vaccines, Inc. C. Y. C. receives research funding from Abbott Laboratories and Delve Bio on unrelated pathogen detection and discovery projects using metagenomic next-generation sequencing and is a cofounder of and owns equity in Delve Bio. C. Y. C. is also on the scientific advisory board for Biomeme, Biomesense, Flightpath Biosciences, Mammoth Biosciences, and Poppy Health. C. K. is a consultant for Ferring/Rebiotix and a scientific advisor for Seres Therapeutics. A. V. A. is a stockholder of Alzeca Inc. and Sensulin LLC and is on the scientific advisory board of Alezeca Inc.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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