The Epidemiology of SARS-CoV-2 in a Pediatric Healthcare Network in the United States.

TitleThe Epidemiology of SARS-CoV-2 in a Pediatric Healthcare Network in the United States.
Publication TypeJournal Article
Year of Publication2020
AuthorsOtto WR, Geoghegan S, Posch LC, Bell LM, Coffin SE, Sammons JS, Harris RM, John AROdom, Luan X, Gerber JS
JournalJ Pediatric Infect Dis Soc
Date Published2020 Jun 19
ISSN2048-7207
Abstract

BACKGROUND: Understanding the prevalence and clinical presentation of COVID-19 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic.

METHODS: Retrospective case series of patients tested for SARS-CoV-2 across a pediatric healthcare network, including the clinical features and outcomes of those with positive test results.

RESULTS: Of 7,256 unique children tested for SARS-CoV-2, 424 (5.8%) tested positive. Patients 18-21 years of age had the highest test positive rate (11.2%) while those 1-5 years of age had the lowest (3.9%). By race, 10.6% (226/2132) of Black children tested positive vs. 3.3% (117/3592) of White children. Of those with an indication for testing, 21.1% (371/1756) of patients with reported exposures or clinical symptoms tested positive vs. 3.8% (53/1410) of those undergoing pre-procedural or pre-admission testing. Of the 424 patients who tested positive for SARS-CoV-2, 182 (42.9%) had no comorbid medical conditions, 87 (20.5%) had asthma, 55 (13.0% had obesity, and 38 (9.0%) had mental health disorders. Overall, 52.1% had cough, 51.2% fever, and 14.6% shortness of breath. Seventy-seven (18.2%) SARS-CoV-2 positive patients were hospitalized, of which 24 (31.2%) required any respiratory support. SARS-CoV-2-targeted antiviral therapy was given to 9 patients, and immunomodulatory therapy to 18 patients. Twelve (2.8%) SARS-CoV-2 positive patients developed critical illness requiring mechanical ventilation and 2 patients required extracorporeal membrane oxygenation. Two patients died.

CONCLUSIONS: In this large cohort of pediatric patients tested for SARS-CoV-2, the rate of infection was low, but varied by testing indication. The majority of cases were mild, few children had critical illness, and two patients died.

DOI10.1093/jpids/piaa074
Alternate JournalJ Pediatric Infect Dis Soc
PubMed ID32559282