Risk factors for COVID-19 hospitalisations and deaths in Mexican children and adolescents: retrospective cross-sectional study.

OBJECTIVE: To describe the epidemiology and risk factors for hospitalisation and death in Mexican children under 18 years of age with COVID-19. DESIGN: Retrospective, cross-sectional and analytical study. SETTING: Mexican Ministry of Health open databases with COVID-19 cases occurred from 7 March 2020 to 30 September 2021. PARTICIPANTS: Mexican children under 18 years of age with COVID-19. MAIN OUTCOME MEASURES: COVID-19 hospitalisations and deaths were characterised by age group, sex, presence of pneumonia and comorbidities, intubation and intensive care unit admission, and institution that provided medical care. Cumulative incidence, mortality, case fatality rates and ORs for hospitalisation and death were estimated by age group. RESULTS: 5.5% (204 641) of national COVID-19 cases were children under 18 years of age: 2.9% under 1 year, 12.5% from 1 to 5 years, 15% from 6 to 9 years and 69.4% from 10 to 17 years. 4.6% of all cases were hospitalised, from which 54.6% were male, 35.3% were children under 1 year old, 39.6% were adolescents and 34% had pneumonia. Pneumonia developed in 2.3% of cases, from which 50% were adolescents. Case fatality rate was higher in children less than 1 year old (4.2%). Risk analyses showed that male sex (OR 1.16-1.28), history of pneumonia (OR 29.7-65.4), immunosuppression (OR 5.3-42.9), cardiovascular disease (OR 4.4-14.6) and other comorbidities (OR 5.4-19.1), as well as age less than 1 year (OR 20.1, 95% CI 18.8 to 21.4), confer a greater risk of hospitalisation; in addition to comorbidities, age less than 1 year (OR 16.6, 95% CI 14.1 to 19.6), history of pneumonia (OR 14.1-135.1) and being an adolescent from an indigenous community (OR 2.6, 95% CI 1.23 to 5.54, p=0.012) increase the risk of death. CONCLUSIONS: In Mexico, children less than 1 year old with COVID-19 have higher risk of hospitalisation and death than older children. Adolescents with COVID-19 in association with comorbidities develop adverse outcomes more frequently.

[Our teenagers: still a pending subject]. / Nuestros adolescentes: una asignatura aún pendiente.

Background: Adolescents (ages 10-19) represent approximately 16% of the population in Mexico. This article identifies their main morbidity and mortality conditions, as well as current strategies and interventions to reduce preventable causes. Objective: Identify the main causes of morbidity, mortality, and disease burden in adolescents from 10 to 19 years of age, and current interventions to reduce mortality and improve adolescent health in the Mexican and international context. Method: A descriptive-exploratory statistical analysis of primary sources was performed to identify the main causes of adolescent morbidity and mortality in Mexico. Through a structured literature search, current policies, and interventions to improve adolescent health were identified. Results: Accidents are the second leading cause of death in adolescents aged 10 to 14 years and in the group of 15 to 19 years. Intentional injuries have increased in recent years, occupying the third cause of death in adolescents between 10 and 14 years old and the first cause of death among youngsters between 15 and 19 years old. Conclusions: The current health system urgently needs restructuring and reengineering, in which adolescent health and wellbeing intervention needs are considered.

Introducción: Los adolescentes (edades entre 10 y 19 años) representan aproximadamente el 16% de la población en México. En este artículo se identifica su principal de morbimortalidad, así como las estrategias e intervenciones actuales para reducir las causas prevenibles. Objetivo: Identificar las principales causas de morbilidad, mortalidad y carga de enfermedad en adolescentes, así como las intervenciones de salud pública actuales para reducir la mortalidad y mejorar la salud de los adolescentes en el contexto mexicano e internacional. Método: Se realizó un análisis estadístico, descriptivo-exploratorio, de fuentes primarias, para determinar las principales causas de morbilidad y mortalidad en adolescentes de México. Mediante búsqueda estructurada de la literatura se identificaron las políticas e intervenciones actuales para mejorar la salud de los adolescentes. Resultados: Los accidentes son la segunda causa de muerte en los adolescentes de 10 a 14 años y en el grupo de 15 a 19 años. Las lesiones intencionales se han incrementado en los últimos años, ocupando la tercera causa de muerte en adolescentes de entre 10 y 14 años y la primera entre los de 15 a 19 años Conclusiones: El actual sistema de salud necesita urgentemente una reestructura y una reingeniería que contemplen las necesidades de intervención en lo que respecta a la salud y el bienestar de nuestros adolescentes.