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Clin Infect Dis . Comparison of influenza and COVID-19-associated hospitalizations among children < 18 years old in the United States-FluSurv-NET (

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2022 May 20;ciac388.
doi: 10.1093/cid/ciac388. Online ahead of print.
Comparison of influenza and COVID-19-associated hospitalizations among children < 18 years old in the United States-FluSurv-NET (October-April 2017-2021) and COVID-NET (October 2020-September 2021)


Miranda J Delahoy[SUP] 1 2 3 [/SUP], Dawud Ujamaa[SUP] 1 2 [/SUP], Christopher A Taylor[SUP] 1 [/SUP], Charisse Cummings[SUP] 1 2 [/SUP], Onika Anglin[SUP] 1 [/SUP], Rachel Holstein[SUP] 1 2 [/SUP], Jennifer Milucky[SUP] 1 [/SUP], Alissa O'Halloran[SUP] 1 2 [/SUP], Kadam Patel[SUP] 1 [/SUP], Huong Pham[SUP] 1 [/SUP], Michael Whitaker[SUP] 1 [/SUP], Arthur Reingold[SUP] 4 5 [/SUP], Shua J Chai[SUP] 4 6 [/SUP], Nisha B Alden[SUP] 7 [/SUP], Breanna Kawasaki[SUP] 7 [/SUP], James Meek[SUP] 8 [/SUP], Kimberly Yousey-Hindes[SUP] 8 [/SUP], Evan J Anderson[SUP] 9 10 11 [/SUP], Kyle P Openo[SUP] 9 10 11 [/SUP], Andy Weigel[SUP] 12 [/SUP], Kenzie Teno[SUP] 12 [/SUP], Libby Reeg[SUP] 13 [/SUP], Lauren Leegwater[SUP] 13 [/SUP], Ruth Lynfield[SUP] 14 [/SUP], Melissa McMahon[SUP] 14 [/SUP], Susan Ropp[SUP] 15 [/SUP], Dominic Rudin[SUP] 15 [/SUP], Alison Muse[SUP] 16 [/SUP], Nancy Spina[SUP] 16 [/SUP], Nancy M Bennett[SUP] 17 [/SUP], Kevin Popham[SUP] 18 [/SUP], Laurie M Billing[SUP] 19 [/SUP], Eli Shiltz[SUP] 19 [/SUP], Melissa Sutton[SUP] 20 [/SUP], Ann Thomas[SUP] 20 [/SUP], William Schaffner[SUP] 21 [/SUP], H Keipp Talbot[SUP] 21 [/SUP], Melanie T Crossland[SUP] 22 [/SUP], Keegan McCaffrey[SUP] 23 [/SUP], Aron J Hall[SUP] 1 [/SUP], Erin Burns[SUP] 2 [/SUP], Meredith McMorrow[SUP] 1 [/SUP], Carrie Reed[SUP] 2 [/SUP], Fiona P Havers[SUP] 1 [/SUP], Shikha Garg[SUP] 1 2 [/SUP]



Affiliations

Abstract

Background: Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children.
Methods: Influenza and COVID-19-associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, two population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19-associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (October 1, 2020-September 30, 2021) was compared to influenza-associated hospitalization rates during the 2017-18 through 2019-20 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared.
Results: Among children <18 years old, the COVID-19-associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017-18 (33.5), 2018-19 (33.8), and 2019-20 (41.7). The COVID-19-associated hospitalization rate was higher among adolescents 12-17 years old (COVID-19: 59.9; influenza range: 12.2-14.1), but similar or lower among children 5-11 (COVID-19: 25.0; influenza range: 24.3-31.7) and 0-4 (COVID-19: 66.8; influenza range: 70.9-91.5) years old. Among children <18 years old, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; p < 0.01). Pediatric deaths were uncommon during both COVID-19- and influenza-associated hospitalizations (0.7% vs 0.5%; p = 0.28).
Conclusions: In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19-associated hospitalization rate during 2020-2021 was higher among adolescents and similar or lower among children <12 years old compared with influenza during the three seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses.

Keywords: COVID-19; SARS-CoV-2; children; influenza; surveillance.
 
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