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The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States.
J Pediatric Infect Dis Soc. 2020 Nov 10; 9(5):523-529.JP

Abstract

BACKGROUND

Understanding the prevalence and clinical presentation of coronavirus disease 2019 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic.

METHODS

This was a retrospective case series of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across a pediatric healthcare network, including clinical features and outcomes of those with positive test results.

RESULTS

Of 7256 unique children tested for SARS-CoV-2, 424 (5.8%) tested positive. Patients aged 18-21 years had the highest test positive rate (11.2%), while those aged 1-5 years had the lowest (3.9%). By race, 10.6% (226/2132) of black children tested positive vs 3.3% (117/3592) of white children. By indication for testing, 21.1% (371/1756) of patients with reported exposures or clinical symptoms tested positive vs 3.8% (53/1410) of those undergoing preprocedural or preadmission testing. Of 424 patients who tested positive for SARS-CoV-2, 182 (42.9%) had no comorbidities, 87 (20.5%) had asthma, and 55 (13.0%) were obese. Overall, 52.1% had cough, 51.2% fever, and 14.6% shortness of breath. Seventy-seven (18.2%) SARS-CoV-2-positive patients were hospitalized, of whom 24 (31.2%) required respiratory support. SARS-CoV-2-targeted antiviral therapy was given to 9 patients, and immunomodulatory therapy to 18 patients. Twelve (2.8%) SARS-CoV-2-positive patients required mechanical ventilation, and 2 patients required extracorporeal membrane oxygenation. Two patients died.

CONCLUSIONS

In this large cohort of pediatric patients tested for SARS-CoV-2, the rate of infection was low but varied by testing indication. The majority of cases were mild and few children had critical illness.

Links

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Authors+Show Affiliations

Otto WR
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Geoghegan S
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. National Children's Research Centre, Dublin, Ireland.
Posch LC
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Bell LM
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Coffin SE
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Sammons JS
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Harris RM
Infectious Disease Diagnostics Laboratory, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Odom John AR
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Luan X
Center for Healthcare Quality and Analytics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Gerber JS
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

MeSH

AdolescentAsymptomatic DiseasesBetacoronavirusCOVID-19COVID-19 TestingChildChild, PreschoolClinical Laboratory TechniquesCoronavirus InfectionsFemaleHospitalizationHumansInfantMaleNew JerseyPandemicsPennsylvaniaPneumonia, ViralPolymerase Chain ReactionRetrospective StudiesSARS-CoV-2

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32559282

Clinical Trial Links

TDCS in Pediatric and Teenage Patients With Major Depressive Disorder During COVID-19 Pandemic

Citation

Otto, William R., et al. "The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States." Journal of the Pediatric Infectious Diseases Society, vol. 9, no. 5, 2020, pp. 523-529.
Otto WR, Geoghegan S, Posch LC, et al. The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States. J Pediatric Infect Dis Soc. 2020;9(5):523-529.
Otto, W. R., Geoghegan, S., Posch, L. C., Bell, L. M., Coffin, S. E., Sammons, J. S., Harris, R. M., Odom John, A. R., Luan, X., & Gerber, J. S. (2020). The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States. Journal of the Pediatric Infectious Diseases Society, 9(5), 523-529. https://doi.org/10.1093/jpids/piaa074
Otto WR, et al. The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States. J Pediatric Infect Dis Soc. 2020 Nov 10;9(5):523-529. PubMed PMID: 32559282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States. AU - Otto,William R, AU - Geoghegan,Sarah, AU - Posch,Leila C, AU - Bell,Louis M, AU - Coffin,Susan E, AU - Sammons,Julia S, AU - Harris,Rebecca M, AU - Odom John,Audrey R, AU - Luan,Xianqun, AU - Gerber,Jeffrey S, PY - 2020/5/11/received PY - 2020/6/18/accepted PY - 2020/6/20/pubmed PY - 2020/11/18/medline PY - 2020/6/20/entrez KW - COVID-19 KW - coronavirus KW - epidemiology KW - testing SP - 523 EP - 529 JF - Journal of the Pediatric Infectious Diseases Society JO - J Pediatric Infect Dis Soc VL - 9 IS - 5 N2 - BACKGROUND: Understanding the prevalence and clinical presentation of coronavirus disease 2019 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic. METHODS: This was a retrospective case series of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across a pediatric healthcare network, including clinical features and outcomes of those with positive test results. RESULTS: Of 7256 unique children tested for SARS-CoV-2, 424 (5.8%) tested positive. Patients aged 18-21 years had the highest test positive rate (11.2%), while those aged 1-5 years had the lowest (3.9%). By race, 10.6% (226/2132) of black children tested positive vs 3.3% (117/3592) of white children. By indication for testing, 21.1% (371/1756) of patients with reported exposures or clinical symptoms tested positive vs 3.8% (53/1410) of those undergoing preprocedural or preadmission testing. Of 424 patients who tested positive for SARS-CoV-2, 182 (42.9%) had no comorbidities, 87 (20.5%) had asthma, and 55 (13.0%) were obese. Overall, 52.1% had cough, 51.2% fever, and 14.6% shortness of breath. Seventy-seven (18.2%) SARS-CoV-2-positive patients were hospitalized, of whom 24 (31.2%) required respiratory support. SARS-CoV-2-targeted antiviral therapy was given to 9 patients, and immunomodulatory therapy to 18 patients. Twelve (2.8%) SARS-CoV-2-positive patients required mechanical ventilation, and 2 patients required extracorporeal membrane oxygenation. Two patients died. CONCLUSIONS: In this large cohort of pediatric patients tested for SARS-CoV-2, the rate of infection was low but varied by testing indication. The majority of cases were mild and few children had critical illness. SN - 2048-7207 UR - https://www.unboundmedicine.com/medline/citation/32559282/The_Epidemiology_of_Severe_Acute_Respiratory_Syndrome_Coronavirus_2_in_a_Pediatric_Healthcare_Network_in_the_United_States_ DB - PRIME DP - Unbound Medicine ER -