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Additional file 1: Supplementary Table 1. Clinical features of symptomatic SARS-CoV-2 infections among 1000 pediatric patients overall and by age group. Supplementary Table 2. Clinical characteristics of hospitalizations among the first 1000 symptomatic pediatric SARS-CoV-2 infections in our network (n = 41 patients hospitalized). Supplementary Table 3. Predictive Model of Hospitalization. Supplementary Figure 1. Histogram presenting age distribution (years) among 1000 symptomatic SARS-CoV-2 positive children and adolescents diagnosed between 3/12/2020 and 9/28/2020. Supplementary Figure 2. Tree diagram of the factors in the model for hospitalization. This classification and regression tree illustrated how the risk factors are related to hospitalization. Among the 1000 children with COVID-19, 4.1% (41) were hospitalized (1), 95.9% were not hospitalized. The strongest predictor of hospitalization was presence of a pre-existing condition (PEC). Among the 177 patients with a PEC, 15.3% were hospitalized vs. 1.7% of those without a PEC. Among those with a PEC, the next best predictor of hospitalization was shortness of breath (SOB). The hospitalization rate was 53.5% among those with both a PEC and SOB vs. 8.1% among those with a PEC but no SOB. Patients who are black or Hispanic were at increased risk of hospitalization among both those with and without PEC. Supplementary Figure 3. Tree diagram of ‘pre-existing conditions’ in the model for hospitalization, and the relative contributions of immunologic, neurologic, and renal conditions to the predictive model. Supplementary Figure 4. Association between Age, Weight, and Hospitalization. The locally weighted scatter plot smoothing lines illustrate the relationship between weight and age in the hospitalized and non-hospitalized patients. The dark bands represent the 95% confidence interval of each line. Supplementary Figure 5. Calibration curve for multivariate model predicting hospitalization. Calibration plot showing predicted probability of hospitalization vs. observed rate of hospitalization

BackgroundCarbapenem-resistant Enterobacterales (CRE) are a global threat. We aimed to describe the clinical and molecular characteristics of Centers for Disease Control and Prevention (CDC)-defined CRE in the USA.MethodsCRACKLE-2 is a prospective, multicentre, cohort study. Patients hospitalised in 49 US hospitals, with clinical cultures positive for CDC-defined CRE between April 30, 2016, and Aug 31, 2017, were included. There was no age exclusion. The primary outcome was desirability of outcome ranking (DOOR) at 30 days after index culture. Clinical data and bacteria were collected, and whole genome sequencing was done. This trial is registered with ClinicalTrials.gov, number NCT03646227.Findings1040 patients with unique isolates were included, 449 (43%) with infection and 591 (57%) with colonisation. The CDC-defined CRE admission rate was 57 per 100 000 admissions (95% CI 45-71). Three subsets of CDC-defined CRE were identified: carbapenemase-producing Enterobacterales (618 [59%] of 1040), non-carbapenemase-producing Enterobacterales (194 [19%]), and unconfirmed CRE (228 [22%]; initially reported as CRE, but susceptible to carbapenems in two central laboratories). Klebsiella pneumoniae carbapenemase-producing clonal group 258 K pneumoniae was the most common carbapenemase-producing Enterobacterales. In 449 patients with CDC-defined CRE infections, DOOR outcomes were not significantly different in patients with carbapenemase-producing Enterobacterales, non-carbapenemase-producing Enterobacterales, and unconfirmed CRE. At 30 days 107 (24%, 95% CI 20-28) of these patients had died.InterpretationAmong patients with CDC-defined CRE, similar outcomes were observed among three subgroups, including the novel unconfirmed CRE group. CDC-defined CRE represent diverse bacteria, whose spread might not respond to interventions directed to carbapenemase-producing Enterobacterales.FundingNational Institutes of Health.