- Posted September 21, 2021
Which Kids Are at Highest Risk From COVID?
Older children and kids with chronic diseases are those most likely to wind up in the hospital with COVID-19, researchers have found.
Conditions such as obesity, diabetes and neurologic problems, among others, put kids at risk for severe COVID-19, according to a new U.S. study.
"There's a myth circulating out there that children don't get sick from COVID-19, and that's kind of persisted throughout the pandemic. And I think our findings dispel that, and we can finally put that to bed," said Dr. James Antoon, who led the study of U.S. kids and COVID-19. He is an assistant professor of pediatrics at Vanderbilt University in Nashville, Tenn.
Antoon noted that one in five kids with COVID-19 seen in U.S. emergency departments are admitted to the hospital, and 21% of them require treatment in an intensive care unit, including mechanical ventilation.
The most frequent complications of COVID-19 among children are pneumonia, vomiting and diarrhea. Asthma attacks are also common, Antoon said. Fortunately, few children die.
"One concerning part of our finding is that children who are eligible to be vaccinated — those older than 12 — are most likely to have more severe disease," Antoon said. "But it's also the group that's the least-vaccinated. We need to do a better job of vaccinating the children who are eligible, and then we also have to think carefully about how do we protect those children with comorbidities who are at very high risk for having severe COVID."
Antoon attributed the increase in pediatric cases to the return to school.
"Certainly, when children congregate they're going to transmit the virus, and there's definitely going to be increased transmission among children, which is going to correlate into more hospitalizations and more severe disease," he explained.
Whether vaccines should be mandated, especially as shots for younger children become available, is a tough question, Antoon said, given the level of the anti-vaxxer movement in the United States.
He added that vaccine mandates are nothing new in the United States, and said a COVID-19 shot should be added to the mix.
"Preventing COVID-19 is much more effective than trying to treat it, because the treatments that we have are not as effective as the vaccines are in preventing severe disease or treating severe disease," Antoon said.
He also urged parents to make sure their kids get the flu shot and take common-sense steps to avoid getting sick.
"Even healthy children can end up in the hospital with COVID-19," Antoon said. "To protect your children and the children around them, please have them vaccinated, wear masks and continue doing the things we know help prevent transmission of COVID."
For the study, Antoon's team collected data on nearly 20,000 pediatric patients at 45 U.S. children's hospitals.
The researchers discovered that children who were in poor health due to chronic conditions — such as obesity, diabetes and neurologic problems — were more likely to have severe COVID-19 and need hospital care. This was especially true for older kids.
Dr. David Katz is president of the True Health Initiative in Tulsa, Okla., which promotes preventing illness by living a healthy lifestyle. He reviewed the new study findings.
"This paper highlights the importance of chronic health status to COVID outcomes in children — something already well established for adults," Katz said.
He noted that obesity and type 2 diabetes, which add to COVID-19 risks, are a growing problem in children that intensified during the pandemic.
"These conditions are all but completely preventable with lifestyle interventions," Katz said. "If this is not an argument for urgent attention to health promotion programming for America's children, it's hard to imagine what would be."
Katz pointed out that the study data noted that while Black children and Hispanic children were less likely to be hospitalized than white youngsters in the United States, they were more likely to be severely ill if hospitalized.
"This, clearly, has nothing to do with skin pigment or ethnicity, and everything to do with differential access and barriers to care," he said. "Those with impaired access to care arrive later and sicker. Here we have a view of direct interactions between social determinants of health and the toll of the pandemic among our children. This, too, is modifiable; this, too, warrants an urgent, national response."
The findings were published online Sept. 15 in the Journal of Hospital Medicine.
The U.S. Centers for Disease Control and Prevention has more about kids and COVID.
SOURCES: James Antoon, MD, PhD, assistant professor, pediatrics and hospital medicine, Vanderbilt University, Nashville, Tenn.; David Katz, MD, MPH, president, True Health Initiative, Tulsa, Okla.; Journal of Hospital Medicine, Sept. 15, 2021, online