NYMC Faculty Publications

Frequency, Characteristics and Complications of COVID-19 in Hospitalized Infants

Authors

Charlotte V. Hobbs, From the Department of Pediatrics, Division of Disease, Microbiology, University of Mississippi Medical Center, Jackson, Mississippi.
Kate Woodworth, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.
Cameron C. Young, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Ashley M. Jackson, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.
Margaret M. Newhams, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Heda Dapul, Department of Pediatrics, Division of Infectious Diseases, New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York.
Mia Maamari, Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Texas.
Mark W. Hall, Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.
Aline B. Maddux, Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.
Aalok R. Singh, Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York.Follow
Jennifer E. Schuster, Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri.
Courtney M. Rowan, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana.
Julie C. Fitzgerald, Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Katherine Irby, Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas.
Michele Kong, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
Elizabeth H. Mack, Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina.
Mary A. Staat, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Natalie Z. Cvijanovich, Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, California.
Melania M. Bembea, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Bria M. Coates, Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Natasha B. Halasa, Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Tracie C. Walker, Department of Pediatrics, Division of Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Gwenn E. McLaughlin, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.
Christopher J. Babbitt, Division of Pediatric Critical Care, Department of Pediatrics, Miller Children's and Women's Hospital of Long Beach, Long Beach, California.
Ryan A. Nofziger, Division of Critical Care Medicine, Akron Children's Hospital, Akron, Ohio.
Laura L. Loftis, Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital, Houston, Texas.
Tamara T. Bradford, Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana.
Angela P. Campbell, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.
Manish M. Patel, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.Follow
Adrienne G. Randolph, Department of Pediatrics, Division of Infectious Diseases, New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York.

Author Type(s)

Faculty

DOI

10.1097/INF.0000000000003435

Journal Title

The Pediatric Infectious Disease Journal

First Page

e81

Last Page

e86

Document Type

Article

Publication Date

3-1-2022

Department

Pediatrics

Abstract

BACKGROUND: Previous studies of severe acute respiratory syndrome coronavirus 2 infection in infants have incompletely characterized factors associated with severe illness or focused on infants born to mothers with coronavirus disease 2019 (COVID-19). Here we highlight demographics, clinical characteristics and laboratory values that differ between infants with and without severe acute COVID-19. METHODS: Active surveillance was performed by the Overcoming COVID-19 network to identify children and adolescents with severe acute respiratory syndrome coronavirus 2-related illness hospitalized at 62 sites in 31 states from March 15 to December 27, 2020. We analyzed patients >7 days to <1 year old hospitalized with symptomatic acute COVID-19. RESULTS: We report 232 infants >7 days to <1 year of age hospitalized with acute symptomatic COVID-19 from 37 US hospitals in our cohort from March 15 to December 27, 2020. Among 630 cases of severe COVID-19 in patients >7 days to <18 years old, 128 (20.3%) were infants. In infants with severe illness from the entire study period, the median age was 2 months, 66% were from racial and ethnic minority groups, 66% were previously healthy, 73% had respiratory complications, 13% received mechanical ventilation and <1% died. CONCLUSIONS: Infants accounted for over a fifth of children <18 years of age hospitalized for severe acute COVID-19, commonly manifesting with respiratory symptoms and complications. Although most infants hospitalized with COVID-19 did not suffer significant complications, longer term outcomes remain unclear. Notably, 75% of infants with severe disease were <6 months of age in this cohort study period, which predated maternal COVID-19 vaccination, underscoring the importance of maternal vaccination for COVID-19 in protecting the mother and infant.

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