What Happens When Children Are Hospitalized With COVID-19

What you need to know

Although many children infected with SARS-CoV-2 — the virus that causes COVID-19 — do not suffer severe symptoms, some do. A recent study supported by the National Center for Advancing Translational Sciences examined what happens to children who are hospitalized with COVID-19 and identified some of the factors that contribute to a child’s admission to the intensive care unit (ICU).

What did the researchers do?

From February 2020 to January 2021, researchers gathered health data on children hospitalized with COVID-19 from 51 hospitals. The study included 874 children younger than 18 years old with mild to severe symptoms of COVID-19. Of the 874 hospitalized children, 404 (46%) were admitted to the ICU, and 16 (2%) died of their symptoms.

What did they learn?

The researchers found that the following factors were associated with a child’s admission to the ICU:

• Older age. For every one-year increase in age, the odds of needing the ICU increased by 4 percent.

• Fever. Sixty-nine percent of children admitted to the ICU had a fever.

• Preexisting seizure disorders. Children with preexisting seizure disorders were more than three times likelier to require intensive care.

• Diagnosis of multisystem inflammatory syndrome in children (MIS-C), a condition that causes inflammation of body parts (e.g., heart, lungs, kidneys, brain, skin, eyes, gastrointestinal organs). Forty-four percent of children admitted to the ICU had MIS-C.

In this study, gastrointestinal issues were the most common symptom in children with COVID-19, although they were not associated with ICU admission or death.

Why is this research important?

Although children are less likely than adults to develop severe symptoms of COVID-19, until they are vaccinated, children remain vulnerable. In this study, almost half of children with symptoms severe enough to require hospitalization were admitted to the ICU. Understanding risk factors for severe COVID-19 can help parents and care providers make better decisions for a child’s health.

Where can I go to learn more?

COVID-19 in Children

• The NIH COVID-19 Treatment Guidelines provide guidance for health care providers who treat children infected with SARS-CoV-2.

COVID-19 and MIS-C

• The Centers for Disease Control and Prevention (CDC) shares resources about MIS-C and COVID-19 in children.

COVID MUSIC Study: Understanding MIS-C

• The National Heart, Lung, and Blood Institute is researching COVID-19 and MIS-C.

Sources

Bhalala, U. S., Gist, K. M., Tripathi, S., Boman, K., Kumar, V. K., Retford, L., Chiotos, K., Blatz, A. M., Dapul, H., Verma, S., Sayed, I. A., Gharpure, V. P., Bjornstad, E., Tofil, N., Irby, K., Sanders, R. C. Jr., Heneghan, J. A., Thomas, M., Gupta, M. K., Oulds, F. E., … Kashyap, R. (2021). Characterization and outcomes of hospitalized children with coronavirus disease 2019: A report from a multicenter, viral infection and respiratory illness universal study (Coronavirus Disease 2019) registry. Critical Care Medicine. Advance online publication. https://doi.org/10.1097/ccm.0000000000005232