COVID-19 Disease Characterization and Outcomes Comparison in Pediatrics.

Background: It has been reported that children experience less severe COVID-19 symptoms than adults; however, the literature that supports this idea is evolving. The purpose of this study was to retrospectively characterize hospitalized COVID-19-positive pediatric patients with a focus on the assessment of risk factors for poorer outcomes, mortality, and evaluation of interventions utilized and associated clinical outcomes.

Methods: We conducted a multi-center retrospective chart review of patients 18 years old or younger who were COVID-19 positive and admitted to any US HCA Healthcare Pediatric service line between January 1, 2020, and November 30, 2020. We identified 6081 children across 4 states and included them in our data analysis. Negative Binomial Regression was used to measure the associations between characteristics abstracted from medical records and length of hospital stay.

Results: Of the total cohort, 2.7% had at least one comorbidity. The majority of patients were discharged shortly after admission with 93.6% of patients spending less than 48 hours as an inpatient. The mortality rate during the study period was 0.1%. Factors found to be significantly associated with an increased length of stay were time in the intensive care unit (ICU), surgeries, developmental disorders, diabetes, post-traumatic stress disorder (PTSD), suicidal ideation, and type of admission.

Conclusion: The results of this cohort show there was a low disease burden at baseline and during hospitalization in pediatric patients positive for COVID-19. However, as the pandemic continues, future studies that further describe COVID-19 in children will be crucial to fully understand the disease course.