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. 2021 Sep 27;193(38):E1483-E1493.
doi: 10.1503/cmaj.210053.

Characteristics of children admitted to hospital with acute SARS-CoV-2 infection in Canada in 2020

Olivier Drouin  1 , Charlotte Moore Hepburn  1 , Daniel S Farrar  1 , Krista Baerg  1 , Kevin Chan  1 , Claude Cyr  1 , Elizabeth J Donner  1 , Joanne E Embree  1 , Catherine Farrell  1 , Sarah Forgie  1 , Ryan Giroux  1 , Kristopher T Kang  1 , Melanie King  1 , Melanie Laffin  1 , Thuy Mai Luu  1 , Julia Orkin  1 , Jesse Papenburg  1 , Catherine M Pound  1 , Victoria E Price  1 , Rupeena Purewal  1 , Manish Sadarangani  1 , Marina I Salvadori  1 , Karina A Top  1 , Isabelle Viel-Thériault  1 , Fatima Kakkar  2 , Shaun K Morris  2 ; Canadian Paediatric Surveillance Program COVID-19 Study Team
Affiliations

Characteristics of children admitted to hospital with acute SARS-CoV-2 infection in Canada in 2020

Olivier Drouin et al. CMAJ. .

Abstract

Background: Risk factors for severe outcomes of SARS-CoV-2 infection are not well established in children. We sought to describe pediatric hospital admissions associated with SARS-CoV-2 infection in Canada and identify risk factors for more severe disease.

Methods: We conducted a national prospective study using the infrastructure of the Canadian Paediatric Surveillance Program (CPSP). Cases involving children who were admitted to hospital with microbiologically confirmed SARS-CoV-2 infection were reported from Apr. 8 to Dec. 31 2020, through weekly online questionnaires distributed to the CPSP network of more than 2800 pediatricians. We categorized hospital admissions as related to COVID-19, incidental, or for social or infection control reasons and determined risk factors for disease severity in hospital.

Results: Among 264 hospital admissions involving children with SARS-CoV-2 infection during the 9-month study period, 150 (56.8%) admissions were related to COVID-19 and 100 (37.9%) were incidental infections (admissions for other reasons and found to be positive for SARS-CoV-2 on screening). Infants (37.3%) and adolescents (29.6%) represented most cases. Among hospital admissions related to COVID-19, 52 (34.7%) had critical disease, 42 (28.0%) of whom required any form of respiratory or hemodynamic support, and 59 (39.3%) had at least 1 underlying comorbidity. Children with obesity, chronic neurologic conditions or chronic lung disease other than asthma were more likely to have severe or critical COVID-19.

Interpretation: Among children who were admitted to hospital with SARS-CoV-2 infection in Canada during the early COVID-19 pandemic period, incidental SARS-CoV-2 infection was common. In children admitted with acute COVID-19, obesity and neurologic and respiratory comorbidities were associated with more severe disease.

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Conflict of interest statement

Competing interests: Krista Baerg reports funding from the Chronic Pain Network. She also served as Past President of the Community Paediatrics Section of the Canadian Paediatric Society and on the Board of Directors for Saskatchewan Pain Society, and has received royalties from Brush Education. Kevin Chan is Chair of the Acute Care Committee of the Canadian Paediatric Society. Elizabeth Donner is Chair of the Scientific Research Committee and a director of Epilepsy Canada. She is also a member of Partners Against Mortality in Epilepsy and the advisory boards of Cardiol, Pendopharm and Stoke Therapeutics. Catherine Farrell is Chair of the Scientific Steering Committee for the Canadian Paediatric Surveillance Program, former Chair of the Specialty Committee in Pediatrics of the Royal College of Physicians and Surgeons of Canada, former President of the Canadian Paediatric Society, and Chair of the Ethics Committee and a member of the Board of Directors of the Canadian Critical Care Society. She has received reimbursement for travel expenses from Canadian Paediatric Society and the Royal College of Physicians and Surgeons of Canada. She has also received an honorarium for a presentation at a continuing education conference from the Université de Sherbrooke. Sarah Forgie is the President of the Association of Medical Microbiology and Infectious Disease Canada. Fatima Kakkar has received honoraria for presentations given to the Association des Pédiatres du Québec. Thuy Mai Luu is the Director of the Canadian Neonatal Follow-Up Network. Charlotte Moore Hepburn is the Director of Children’s Mental Health of Ontario, and the Director of medical affairs for the Canadian Paediatric Society and the Canadian Paediatric Surveillance Program. Shaun Morris has received honouraria for lectures from GlaxoSmithKline. He was a member of an ad hoc advisory board for Pfizer Canada. Jesse Papenburg has received consultant fees from AbbVie, honouraria from AbbVie and Seegene, and he received respiratory virus testing materials from Seegene for his institution. He has participated in ad hoc advisory board meetings for AbbVie and is a voting member of the National Advisory Committee on Immunization. Rupeena Purewal is a consultant for Verity Pharmaceuticals. Manish Sadarangani is a member of the advisory board of Astra Zeneca. Marina Salvadori is an employee of the Public Health Agency of Canada. No other competing interests were declared.

Figures

Figure 1:
Figure 1:
Flow chart of cases reported to the Canadian Paediatric Surveillance Program (CPSP) COVID-19 study with a diagnosis of SARS-CoV-2 infection on or before Dec. 31, 2020.
Figure 2:
Figure 2:
Hospital admissions for acute SARS-CoV-2 infections involving children, by calendar month and region of residence. Note: Number of new cases admitted in each month. Note: Western/Northern includes Alberta, British Columbia, Manitoba, Northwest Territories, Nunavut, Saskatchewan and Yukon. Atlantic includes Newfoundland and Labrador, New Brunswick, Nova Scotia and Prince Edward Island.
See this image and copyright information in PMC

Comment in

References

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