Risk factors for severe disease and mortality in children with COVID-19.

ABSTRACT

Background: Pediatric COVID-19 patients have lower rates of hospitalization and fatal outcomes compared to adults with COVID-19; however, children represent a challenge in the detection, diagnosis, and treatment of COVID-19. Our aim was to determine the risk factors for hospital admission, invasive mechanical ventilation, and mortality in pediatric COVID-19 patients in Mexico during the COVID-19 pandemic. Material and methods: A retrospective cohort of pediatric patients with COVID-19 from February 2020 to April 2021 was reported on the National Epidemiological Surveillance System for Viral Respiratory Disease (SISVER) platform. Results: Among the 104,133 patients included in our study, 6214 were hospitalized, and 621 patients underwent invasive mechanical ventilation. A total of 0.65 % died during hospitalization. Children aged <12 months (odds ratio [OR] 17.1; 95 % confidence interval [CI] 15.9-19.4, p < 0.001), 1-4 years (OR 3.69; 95 % CI 3.2-4.1, p < 0.001), 5-9 years (OR 1.86; 95 % CI 1.66-2.08, p < 0.001), and 10-14 years (OR 1.23; 95 % CI 1.11-1.37, p < 0.001), and those diagnosed with diabetes (OR 2.32; 95 % CI 1.68-3.20, p < 0.001) and obesity (OR 1.24; 95 % CI 1.04-1.48, p = 0.015) were associated with hospital admission. Renal disease (OR 3.85; 95 % CI 2.25-6.59, p < 0.001) was associated with invasive mechanical ventilation. Pneumonia (OR 15.9; 95 % CI 12.6-20.1, p < 0.001) and renal disease (OR 3.85; 95 % CI 2.25-6.59, p value < 0.001) were associated with death. Conclusion: Pneumonia increases the risk of death. The youngest age group has a higher risk of hospital admission. Comorbidities such as renal disease or immunosuppression increase the risk of death in all age groups.