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Baseline characteristics, management, and outcomes of 55,270 children and adolescents diagnosed with COVID-19 and 1,952,693 with influenza in France, Germany, Spain, South Korea and the United States: an international network cohort study

Authors :
Lin Zhang
Martina Recalde
Carlos Areia
Vojtech Huser
Andrew E. Williams
Andrea Pistillo
Thamir M. Alshammari
Kristin Kostka
Heba Alghoul
Christian G. Reich
Karishma Shah
Nigam H. Shah
Paula Casajust
Clair Blacketer
Jose D. Posada
Albert Prats-Uribe
Eng Hooi Tan
Mengchun Gong
Marc A. Suchard
David Vizcaya
Seng Chan You
Elena Roel
Thomas Falconer
Osaid Alser
Daniel Prieto-Alhambra
Lisa M. Schilling
Waheed-Ul-Rahman Ahmed
Stephen Fortin
Scott L. DuVall
Talita Duarte-Salles
Edward Burn
Anthony G. Sena
Sergio Fernandez-Bertolin
Lana Yin Hui Lai
Pablo Iveli
Daniel R. Morales
Fredrik Nyberg
Asieh Golozar
Source :
medRxiv
Publication Year :
2020
Publisher :
Cold Spring Harbor Laboratory, 2020.

Abstract

ObjectivesTo characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children/adolescents diagnosed or hospitalized with COVID-19. Secondly, to describe health outcomes amongst children/adolescents diagnosed with previous seasonal influenza.DesignInternational network cohort.SettingReal-world data from European primary care records (France/Germany/Spain), South Korean claims and US claims and hospital databases.ParticipantsDiagnosed and/or hospitalized children/adolescents with COVID-19 at age Main outcome measuresBaseline demographics and comorbidities, symptoms, 30-day in-hospital treatments and outcomes including hospitalization, pneumonia, acute respiratory distress syndrome (ARDS), multi-system inflammatory syndrome (MIS-C), and death.ResultsA total of 55,270 children/adolescents diagnosed and 3,693 hospitalized with COVID-19 and 1,952,693 diagnosed with influenza were studied.Comorbidities including neurodevelopmental disorders, heart disease, and cancer were all more common among those hospitalized vs diagnosed with COVID-19. The most common COVID-19 symptom was fever. Dyspnea, bronchiolitis, anosmia and gastrointestinal symptoms were more common in COVID-19 than influenza.In-hospital treatments for COVID-19 included repurposed medications (Hospitalization was observed in 0.3% to 1.3% of the COVID-19 diagnosed cohort, with undetectable (NConclusionsDespite negligible fatality, complications including pneumonia, ARDS and MIS-C were more frequent in children/adolescents with COVID-19 than with influenza. Dyspnea, anosmia and gastrointestinal symptoms could help differential diagnosis. A wide range of medications were used for the inpatient management of pediatric COVID-19.What is already known on this topic?Most of the early COVID-19 studies were targeted at adult patients, and data concerning children and adolescents are limited.Clinical manifestations of COVID-19 are generally milder in the pediatric population compared with adults.Hospitalization for COVID-19 affects mostly infants, toddlers, and children with pre-existing comorbidities.What this study adds⍰This study comprehensively characterizes a large international cohort of pediatric COVID-19 patients, and almost 2 million with previous seasonal influenza across 5 countries.⍰Although uncommon, pneumonia, acute respiratory distress syndrome (ARDS) and multi-system inflammatory syndrome (MIS-C) were more frequent in children and adolescents diagnosed with COVID-19 than in those with seasonal influenza.⍰Dyspnea, bronchiolitis, anosmia and gastrointestinal symptoms were more frequent in COVID-19, and could help to differentiate pediatric COVID-19 from influenza.⍰A plethora of medications were used during the management of COVID-19 in children and adolescents, with great heterogeneity in the use of antiviral therapies as well as of adjunctive therapies.

Details

Database :
OpenAIRE
Journal :
medRxiv
Accession number :
edsair.doi.dedup.....c6c5e91dafda8a9dfc3120e894a0a681