Study reveals risk factors for severe COVID-19, related syndrome in kidsA prospective cohort study of US children diagnosed as having COVID-19 reveals that certain demographic characteristics, preexisting chronic diseases, and initial vital sign and lab values may portend disease severity, a finding that the researchers said could help improve outcomes.The University of Colorado-led study involved 167,262 COVID-19 patients 18 years and younger tested for COVID-19 at 56 US National COVID Cohort Collaborative facilities up to Sep 24, 2021, before the emergence of the highly transmissible Omicron SARS-CoV-2 variant.Among the 10,245 hospitalized children (6.1%), 1,423 (13.9%) were severely ill, with 7.8% requiring mechanical ventilation, 8.5% receiving vasopressor-inotropic support to treat low blood pressure, 0.4% needing extracorporeal membrane oxygenation, and 1.3% dying.Severe disease was associated with male sex (odds ratio [OR], 1.37), obesity (OR, 1.19) and some pediatric complex chronic condition (PCCC) subcategories.
Vital signs and many lab test values from the day of admission were predictive of peak disease severity.Factors associated with increased odds of multisystem inflammatory syndrome in children (MIS-C), a rare but serious hyperinflammatory complication of COVID-19, included male sex (OR, 1.59), Black race (OR, 1.44), age younger than 12 years (OR, 1.81), obesity (OR, 1.76), and not having a PCCC (OR, 0.72).The 707 children diagnosed as having MIS-C had a more inflammatory laboratory profile and severe clinical phenotype than the 8,241 with acute illness, with higher rates of invasive ventilation (16.5% vs 6.2%) and need for vasoactive-inotropic cardiac support (27.0% vs 5.2%).There was no significant