Infectious Disease

The speed of pediatric COVID-19 hospital stays has elevated

January 11, 2021

3 min read

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Disclosure:
Karaca-Mandic reports on funding from the University of Minnesota University of Minnesota Office of Academic Clinical Affairs and United Health Foundation grants while conducting the study. personal fees from Tactile Medical, Precision Health Economics, and Semper Health; and grants from the Agency for Research and Quality in Health Care, the American Cancer Society, the National Institute for Health Management, the National Institute on Drug Abuse, and the NIH outside of the work submitted. In the study you will find all relevant financial information from all other authors.

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An analysis of data from 22 US states found a more than eight-fold increase in the hospitalization rate of children with COVID-19 over a 6-month period, according to a study published in JAMA Pediatrics.

Pinar Karaca-Mandic

“Unfortunately, the message of ‘lower risk’ in children was misunderstood by many as ‘no risk’ until several children were diagnosed with multisystem inflammatory syndrome in children.” Pinar Karaca-Mandic, PhD, Professor of Healthcare Risk Management and Academic Director of the Medical Industry Leadership Institute at the University of Minnesota’s Carlson School of Management, told Healio

“Unfortunately, testing in children was not comprehensive and consistent in order to get a good understanding of the prevalence of cases and the rate of infection in children,” Karaca-Mandic said. “Our study shows that children get sick and can be hospitalized, while fortunately most children have less severe symptoms.”

According to data from the Minnesota COVID-19 Hospitalization Tracking Project, there were 5,364 pediatric COVID-19 hospitalizations from May 15 to November 15, Karaca-Mandic and colleagues reported. During the study period, the average cumulative hospital stay rate increased from 2 per 100,000 children to 17.2 per 100,000 children.

Large differences were found between the countries assessed. Hawaii and Rhode Island had the lowest rates of pediatric hospitalization at baseline at 0 cases per 100,000 children, while New Jersey and Colorado had the highest rates at 5 and 4.4 per 100,000 children, respectively.

By November, at the end of the study period, Hawaii still had one of the lowest hospitalization rates at 4.3 per 100,000 children, topping Rhode Island with 3.4 hospitalizations per 100,000 children, while South Dakota and Arizona had 33.7 Hospital admissions were leading or 32.8 per 100,000.

The authors found a significant variance in the extent of the change from the beginning of the study period to the end of the 6-month analysis. The rates in Hawaii and New Hampshire only increased by 4.3 and 1 per 100,000 children, compared to the growth rates in Arizona and South Dakota, where the rates increased by 32 and 31.2 per 100,000 children, respectively.

Several states had significant growth in 3 months, the authors reported. In Utah, hospitalization rates started at 0.3 per 100,000 children and rose to 15.5 per 100,000 children, an increase of 5,067%.

“The takeaway for parents and doctors is to understand that while children with COVID-19 are much less likely to get serious illnesses, some children get very sick,” said Karaca-Mandic. “In our study, by November 15, more than 17 children per 100,000 children had a COVID-19 hospital stay. [The corresponding] The cumulative adult hospitalization rate was 282 per 100,000 adults. Parents in particular should understand the symptoms of COVID, be aware of early signs of deterioration, and closely monitor their children until they have fully recovered. “

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Samir S. Shah, MD, MSCE

Samir S. Shah |

The authors used data on COVID-19 hospitalizations from 22 states and combined that data with U.S. census estimates to determine the incidence of pediatric COVID-19 hospitalizations.

Not surprisingly, child hospitalization rates varied between states. In some states, the rate of COVID-19 pediatric hospital stays rose dramatically between May and November, but not in others. For example, Arizona, Hawaii, South Dakota, and Utah had growth rates greater than 1,000%, but Massachusetts and New Hampshire had less than double that rate. These dramatic increases, or lack thereof, are likely due in large part to public health policies implemented at the state level. States with relatively small increases in COVID-19 hospital stays often used early lockdowns, gradual reopenings, mask mandates, and quarantine strategies for travelers or visitors to states. This study highlights the importance of a solid public health response to the pandemic as a means of protecting children.

In addition, changes in hospitalization rates in children tended to reflect changes in hospitalization rates in adults. States with the highest adult hospitalization rates generally had the highest child hospitalization rates. Children consistently accounted for 2% to 4% of all COVID-related hospital stays in most states during the final stages of the pandemic, although many states switched to distance learning early in the 2020-2021 school year. These results, combined with other data, suggest that pediatric COVID-19 transmission is often outside of the school setting. We need to develop strategies that focus on protecting children.

Samir S. Shah, MD, MSCE

Director and attending physician

Hospital Medicine Department

Cincinnati Children’s Hospital Medical Center

Disclosure: Shah does not report any relevant financial information.

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