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Multicenter Study
. 2022 Jun:245:102-110.e2.
doi: 10.1016/j.jpeds.2022.02.048. Epub 2022 Feb 28.

Comorbidities Associated with Hospitalization and Progression Among Adolescents with Symptomatic Coronavirus Disease 2019

Jeffrey I Campbell  1 , Melanie M Dubois  1 , Timothy J Savage  2 , M Indriati Hood-Pishchany  1 , Tanvi S Sharma  1 , Carter R Petty  3 , Gabriella S Lamb  1 , Mari M Nakamura  4 ; Pediatric COVID-19 US Registry
Affiliations
Multicenter Study

Comorbidities Associated with Hospitalization and Progression Among Adolescents with Symptomatic Coronavirus Disease 2019

Jeffrey I Campbell et al. J Pediatr. 2022 Jun.

Abstract

Objective: To identify subgroups likely to benefit from monoclonal antibody and antiviral therapy by evaluating the relationship between comorbidities and hospitalization among US adolescents with symptomatic coronavirus disease 2019 (COVID-19).

Study design: We analyzed the relationship between presence of comorbidities and need for hospitalization within 28 days of COVID-19 diagnosis for adolescents aged 12-17 years listed in the Pediatric COVID-19 US registry, a multicenter retrospective cohort of US pediatric patients with COVID-19. Comorbidities assessed included obesity, chronic kidney disease (CKD), diabetes, immunosuppressive disease or treatment, sickle cell disease (SCD), heart disease, neurologic disease/neurodevelopmental disorders, and pulmonary disease (excluding patients with mild asthma). We used multivariable logistic regression to determine race/ethnicity-adjusted associations between comorbidities and hospitalization.

Results: A total of 1877 patients met our inclusion criteria, of whom 284 (15%) were hospitalized within 28 days of their COVID-19 diagnosis. In a race/ethnicity-adjusted model, the following comorbidities were independently associated with increased odds of hospitalization: SCD (aOR, 6.9; 95% CI, 3.0-15.9), immunocompromising condition (aOR, 6.4; 95% CI, 3.8-10.8), obesity (aOR, 3.2; 95% CI, 2.1-4.9), diabetes (aOR, 3.0; 95% CI, 1.4-6.2), neurologic disease (aOR, 2.8; 95% CI, 1.8-4.3), and pulmonary disease (excluding mild asthma) (aOR, 1.9; 95% CI, 1.2-3.1). Heart disease and CKD were not independently associated with hospitalization.

Conclusions: SCD, immunocompromising conditions, obesity, diabetes, neurologic disease, and pulmonary disease (excluding mild asthma) were associated with hospitalization for symptomatic COVID-19. Adolescents with acute COVID-19 and these comorbidities should be prioritized for consideration of therapy to avert hospitalization.

Keywords: COVID-19; adolescent; hospitalization; monoclonal antibodies; pediatrics.

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Figures

Figure 1
Figure 1
Diagram of included patients.
Figure 2
Figure 2
Associations among comorbidities, hospitalization, and ICU admission.
See this image and copyright information in PMC

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