Underlying Medical Conditions Up Risk for Severe COVID-19 in Children

A higher risk for severe COVID-19 illness can be found among children with medical complexity and certain underlying conditions, according to a study published online June 7 in JAMA Network Open.

Lyudmyla Kompaniyets, Ph.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined the risk for severe COVID-19 illness among children associated with underlying medical conditions and medical complexity. The analysis included emergency department or inpatient encounters (March 2020 through January 2021) captured in the Premier Healthcare Database Special COVID-19 Release database of 800 hospitals (43,465 youth with COVID-19).

The researchers found that 28.7 percent of patients had underlying medical conditions, most commonly asthma (10.2 percent), neurodevelopmental disorders (3.9 percent), anxiety and fear-related disorders (3.2 percent), depressive disorders (2.8 percent), and obesity (2.5 percent). Hospitalization was most strongly associated with type 1 diabetes (adjusted risk ratio [aRR], 4.60) and obesity (aRR, 3.07), while the strongest risk factors for severe COVID-19 illness were type 1 diabetes (aRR, 2.38) and cardiac and circulatory congenital anomalies (aRR, 1.72). In children younger than 2 years, prematurity was a risk factor for severe COVID-19 illness (aRR, 1.83). Chronic and complex chronic disease were risk factors for hospitalization, with aRRs of 2.91 and 7.86, respectively, as well as for severe COVID-19 illness, with aRRs of 1.95 and 2.86, respectively.

"Public health prevention and vaccine prioritization efforts might consider the potential for severe COVID-19 illness among children with these underlying medical conditions and chronic disease," the authors write.