Mary Wilson
Well-known member
Published 05 July 2023
Cite this as: BMJ 2023;382:e073639
doi: https://doi.org/10.1136/bmj-2022-073639
Harrison Wilde, doctoral student12, Christopher Tomlinson, doctoral student234, Bilal A Mateen, Clinical ecturer data science245, DavidSelby, research fellow 67, Hari Krishnan Kanthimathinathan, PICU consultant8, Padmanabhan Ramnarayan, reader PICU9, Pascale Du Pre, PICU consultant10, Mae Johnson, PICU consultant10, Nazima Pathan, associate professor PICU11, Arturo Gonzalez-Izquierdo, research associate epidemiology2, Alvina G Lai, associate professor health informatics2, Deepti Gurdasani, senior lecturer machine learning1213, Christina Pagel, professor operational research14, Spiros Denaxas, professor health informatics24, Sebastian Vollmer, professor artificial intelligence67, Katherine Brown, professor PICU1510 on behalf of the CVD-COVID-UK/COVID-IMPACT consortium
Abstract
Objective To describe hospital admissions associated with SARS-CoV-2 infection in children and adolescents.
Design Cohort study of 3.2 million first ascertained SARS-CoV-2 infections using electronic health care record data.
Setting England, July 2020 to February 2022.
Participants About 12 million children and adolescents (age <18 years) who were resident in England.
Main outcome measures Ascertainment of a first SARS-CoV-2 associated hospital admissions: due to SARS-CoV-2, with SARS-CoV-2 as a contributory factor, incidental to SARS-CoV-2 infection, and hospital acquired SARS-CoV-2.
Results 3 226 535 children and adolescents had a recorded first SARS-CoV-2 infection during the observation period, and 29 230 (0.9%) infections involved a SARS-CoV-2 associated hospital admission. The median length of stay was 2 (interquartile range 1-4) days) and 1710 of 29 230 (5.9%) SARS-CoV-2 associated admissions involved paediatric critical care. 70 deaths occurred in which covid-19 or paediatric inflammatory multisystem syndrome was listed as a cause, of which 55 (78.6%) were in participants with a SARS-CoV-2 associated hospital admission. SARS-CoV-2 was the cause or a contributory factor in 21 000 of 29 230 (71.8%) participants who were admitted to hospital and only 380 (1.3%) participants acquired infection as an inpatient and 7855 (26.9%) participants were admitted with incidental SARS-CoV-2 infection. Boys, younger children (<5 years), and those from ethnic minority groups or areas of high deprivation were more likely to be admitted to hospital (all P<0.001). The covid-19 vaccination programme in England has identified certain conditions as representing a higher risk of admission to hospital with SARS-CoV-2: 11 085 (37.9%) of participants admitted to hospital had evidence of such a condition, and a further 4765 (16.3%) of participants admitted to hospital had a medical or developmental health condition not included in the vaccination programme’s list.
Conclusions Most SARS-CoV-2 associated hospital admissions in children and adolescents in England were due to SARS-CoV-2 or SARS-CoV-2 was a contributory factor. These results should inform future public health initiatives and research.
https://www.bmj.com/content/382/bmj-2022-073639
Cite this as: BMJ 2023;382:e073639
doi: https://doi.org/10.1136/bmj-2022-073639
Harrison Wilde, doctoral student12, Christopher Tomlinson, doctoral student234, Bilal A Mateen, Clinical ecturer data science245, DavidSelby, research fellow 67, Hari Krishnan Kanthimathinathan, PICU consultant8, Padmanabhan Ramnarayan, reader PICU9, Pascale Du Pre, PICU consultant10, Mae Johnson, PICU consultant10, Nazima Pathan, associate professor PICU11, Arturo Gonzalez-Izquierdo, research associate epidemiology2, Alvina G Lai, associate professor health informatics2, Deepti Gurdasani, senior lecturer machine learning1213, Christina Pagel, professor operational research14, Spiros Denaxas, professor health informatics24, Sebastian Vollmer, professor artificial intelligence67, Katherine Brown, professor PICU1510 on behalf of the CVD-COVID-UK/COVID-IMPACT consortium
Abstract
Objective To describe hospital admissions associated with SARS-CoV-2 infection in children and adolescents.
Design Cohort study of 3.2 million first ascertained SARS-CoV-2 infections using electronic health care record data.
Setting England, July 2020 to February 2022.
Participants About 12 million children and adolescents (age <18 years) who were resident in England.
Main outcome measures Ascertainment of a first SARS-CoV-2 associated hospital admissions: due to SARS-CoV-2, with SARS-CoV-2 as a contributory factor, incidental to SARS-CoV-2 infection, and hospital acquired SARS-CoV-2.
Results 3 226 535 children and adolescents had a recorded first SARS-CoV-2 infection during the observation period, and 29 230 (0.9%) infections involved a SARS-CoV-2 associated hospital admission. The median length of stay was 2 (interquartile range 1-4) days) and 1710 of 29 230 (5.9%) SARS-CoV-2 associated admissions involved paediatric critical care. 70 deaths occurred in which covid-19 or paediatric inflammatory multisystem syndrome was listed as a cause, of which 55 (78.6%) were in participants with a SARS-CoV-2 associated hospital admission. SARS-CoV-2 was the cause or a contributory factor in 21 000 of 29 230 (71.8%) participants who were admitted to hospital and only 380 (1.3%) participants acquired infection as an inpatient and 7855 (26.9%) participants were admitted with incidental SARS-CoV-2 infection. Boys, younger children (<5 years), and those from ethnic minority groups or areas of high deprivation were more likely to be admitted to hospital (all P<0.001). The covid-19 vaccination programme in England has identified certain conditions as representing a higher risk of admission to hospital with SARS-CoV-2: 11 085 (37.9%) of participants admitted to hospital had evidence of such a condition, and a further 4765 (16.3%) of participants admitted to hospital had a medical or developmental health condition not included in the vaccination programme’s list.
Conclusions Most SARS-CoV-2 associated hospital admissions in children and adolescents in England were due to SARS-CoV-2 or SARS-CoV-2 was a contributory factor. These results should inform future public health initiatives and research.
https://www.bmj.com/content/382/bmj-2022-073639