Study: Children Also Face Risk for Severe COVID-19 Complications

May 15, 2020

New research suggests children and young adults are at greater risk for severe complications from COVID-19 than previously thought.

A new study found children, teenagers, and young adults are at greater risk for severe complications from coronavirus disease 2019 (COVID-19) than previously thought, and those with underlying health conditions are at an even greater risk.

“The idea that COVID-19 is sparing of young people is just false,” said coauthor Lawrence Kleinman, MD, professor and vice chair for academic development and chief of the Department of Pediatrics’ Division of Population Health, Quality and Implementation Science at Rutgers Robert Wood Johnson Medical School, in a Rutgers University press release. “While children are more likely to get very sick if they have other chronic conditions, including obesity, it is important to note that children without chronic illness are also at risk. Parents need to continue to take the virus seriously.”

The cross-sectional study—published May 11, 2020 in JAMA Pediatrics—is the first to describe the characteristics of seriously ill pediatric COVID-19 patients in North America.

The idea that COVID-19 is sparing of young people is just false...it is important to note that children without chronic illness are also at risk. Parents need to continue to take the virus seriously.

Researchers followed 48 patients aged ≤21 years with COVID-19 who were admitted to pediatric intensive care units in the US and Canada between March 14 and April 3, 2020 with follow-up to April 10, 2020.

Over 80% of participants had chronic underlying conditions (eg, immune suppression, obesity, diabetes, seizures, chronic lung disease) and of those, 40% depended on technological support due to developmental delays or genetic anomalies.

Overall, >20% of patients experienced failure of ≥2 organ systems due to COVID-19, and approximately 40% required a breathing tube and ventilator.

At the end of the follow-up period, approximately 33% of participants were still hospitalized due to COVID-19, with 3 still requiring ventilator support and 1 on life support.

The authors also wrote in the study that they were “cautiously encouraged” that the overall case fatality rate was 4.2% compared with published mortality rates as high as 62% among adults admitted to the intensive care unit.

In the Rutgers University press release, Kleinman also addressed the growing concern over heart failure and the Kawasaki disease-like condition (termed pediatric multisystem inflammatory syndrome) that is being seen in pediatric COVID-19 patients.

“Although our data collection for this study has ended, we continue to develop collaborations with colleagues in our region and across the country to try to understand these more severe complications,” said Kleinman.

For more COVID-19 coverage for primary care, visit our COVID-19 Resource Page.