1. Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments
- Author
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Funk, Anna L., Florin, Todd A., Kuppermann, Nathan, Tancredi, Daniel J., Xie, Jianling, Kim, Kelly, Neuman, Mark I., Ambroggio, Lilliam, Plint, Amy C., Mintegi, Santiago, Klassen, Terry P., Salvadori, Marina I., Malley, Richard, Payne, Daniel C., Simon, Norma-Jean, Yock-Corrales, Adriana, Nebhrajani, Jasmine R., Chaudhari, Pradip P., Breslin, Kristen A., Finkelstein, Yaron, Campos, Carmen, Bergmann, Kelly R., Bhatt, Maala, Ahmad, Fahd A., Gardiner, Michael A., Avva, Usha R., Shah, Nipam P., Sartori, Laura F., Sabhaney, Vikram J., Caperell, Kerry, Navanandan, Nidhya, Borland, Meredith L., Morris, Claudia R., Gangoiti, Iker, Pavlicich, Viviana, Kannikeswaran, Nirupama, Lunoe, Maren M., Rino, Pedro B., Kam, April J., Cherry, Jonathan C., Rogers, Alexander J., Chong, Shu-Ling, Palumbo, Laura, Angelats, Carlos M., Morrison, Andrea K., Kwok, Maria Y., Becker, Sarah M., Dixon, Andrew C., Poonai, Naveen, Eckerle, Michelle, Wassem, Muhammad, Dalziel, Stuart R., and Freedman, Stephen B.
- Subjects
Male ,Adolescent ,SARS-CoV-2 ,Research ,Infant, Newborn ,COVID-19 ,Infant ,Pediatrics ,Severity of Illness Index ,Hospitalization ,Online Only ,COVID-19 Testing ,Risk Factors ,Child, Preschool ,Odds Ratio ,Humans ,Female ,Prospective Studies ,Child ,Emergency Service, Hospital ,Original Investigation ,Follow-Up Studies - Abstract
Key Points Question What proportion of SARS-CoV-2–positive youths tested in emergency departments (ED) experience severe outcomes (ie, intensive interventions, severe organ impairment, or death) within 14 days? Findings Among 3221 SARS-CoV-2–positive youths enrolled in a global prospective cohort study with outcome data, 3.3% had severe outcomes within 14 days. Across a subgroup of 2510 SARS-CoV-2–positive youths discharged home after testing, 0.5% had severe outcomes during the 2-week follow-up period. Meaning The findings of this study suggest that risk factors such as age, underlying chronic illness, and symptom duration may be useful for clinicians to consider when evaluating pediatric patients with SARS-CoV-2 infection., This cohort study investigates the prevalence of severe outcomes among youths aged 17 years or younger within 14 days of testing positive for SARS-CoV-2 in emergency departments in 8 countries., Importance Severe outcomes among youths with SARS-CoV-2 infections are poorly characterized. Objective To estimate the proportion of children with severe outcomes within 14 days of testing positive for SARS-CoV-2 in an emergency department (ED). Design, Setting, and Participants This prospective cohort study with 14-day follow-up enrolled participants between March 2020 and June 2021. Participants were youths aged younger than 18 years who were tested for SARS-CoV-2 infection at one of 41 EDs across 10 countries including Argentina, Australia, Canada, Costa Rica, Italy, New Zealand, Paraguay, Singapore, Spain, and the United States. Statistical analysis was performed from September to October 2021. Exposures Acute SARS-CoV-2 infection was determined by nucleic acid (eg, polymerase chain reaction) testing. Main Outcomes and Measures Severe outcomes, a composite measure defined as intensive interventions during hospitalization (eg, inotropic support, positive pressure ventilation), diagnoses indicating severe organ impairment, or death. Results Among 3222 enrolled youths who tested positive for SARS-CoV-2 infection, 3221 (>99.9%) had index visit outcome data available, 2007 (62.3%) were from the United States, 1694 (52.6%) were male, and 484 (15.0%) had a self-reported chronic illness; the median (IQR) age was 3 (0-10) years. After 14 days of follow-up, 735 children (22.8% [95% CI, 21.4%-24.3%]) were hospitalized, 107 (3.3% [95% CI, 2.7%-4.0%]) had severe outcomes, and 4 children (0.12% [95% CI, 0.03%-0.32%]) died. Characteristics associated with severe outcomes included being aged 5 to 18 years (age 5 to
- Published
- 2022