Dataset Information

Outcomes of SARS-CoV-2-Positive Youths Tested in Emergency Departments: The Global PERN-COVID-19 Study.

ABSTRACT:

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 <10 years vs <1 year: odds ratio [OR], 1.60 [95% CI, 1.09-2.34]; age 10 to <18 years vs <1 year: OR, 2.39 [95% CI 1.38-4.14]), having a self-reported chronic illness (OR, 2.34 [95% CI, 1.59-3.44]), prior episode of pneumonia (OR, 3.15 [95% CI, 1.83-5.42]), symptoms starting 4 to 7 days prior to seeking ED care (vs starting 0-3 days before seeking care: OR, 2.22 [95% CI, 1.29-3.82]), and country (eg, Canada vs US: OR, 0.11 [95% CI, 0.05-0.23]; Costa Rica vs US: OR, 1.76 [95% CI, 1.05-2.96]; Spain vs US: OR, 0.51 [95% CI, 0.27-0.98]). Among a subgroup of 2510 participants discharged home from the ED after initial testing and who had complete follow-up, 50 (2.0%; 95% CI, 1.5%-2.6%) were eventually hospitalized and 12 (0.5%; 95% CI, 0.3%-0.8%) had severe outcomes. Compared with hospitalized SARS-CoV-2-negative youths, the risk of severe outcomes was higher among hospitalized SARS-CoV-2-positive youths (risk difference, 3.9%; 95% CI, 1.1%-6.9%).

Conclusions and relevance

In this study, approximately 3% of SARS-CoV-2-positive youths tested in EDs experienced severe outcomes within 2 weeks of their ED visit. Among children discharged home from the ED, the risk was much lower. Risk factors such as age, underlying chronic illness, and symptom duration may be useful to consider when making clinical care decisions.

SUBMITTER: Funk AL

PROVIDER: S-EPMC8753506 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Outcomes of SARS-CoV-2-Positive Youths Tested in Emergency Departments: The Global PERN-COVID-19 Study.

Funk Anna L AL Florin Todd A TA Kuppermann Nathan N Tancredi Daniel J DJ Xie Jianling J Kim Kelly K Neuman Mark I MI Ambroggio Lilliam L Plint Amy C AC Mintegi Santiago S Klassen Terry P TP Salvadori Marina I MI Malley Richard R Payne Daniel C DC Simon Norma-Jean NJ Yock-Corrales Adriana A Nebhrajani Jasmine R JR Chaudhari Pradip P PP Breslin Kristen A KA Finkelstein Yaron Y Campos Carmen C Bergmann Kelly R KR Bhatt Maala M Ahmad Fahd A FA Gardiner Michael A MA Avva Usha R UR Shah Nipam P NP Sartori Laura F LF Sabhaney Vikram J VJ Caperell Kerry K Navanandan Nidhya N Borland Meredith L ML Morris Claudia R CR Gangoiti Iker I Pavlicich Viviana V Kannikeswaran Nirupama N Lunoe Maren M MM Rino Pedro B PB Kam April J AJ Cherry Jonathan C JC Rogers Alexander J AJ Chong Shu-Ling SL Palumbo Laura L Angelats Carlos M CM Morrison Andrea K AK Kwok Maria Y MY Becker Sarah M SM Dixon Andrew C AC Poonai Naveen N Eckerle Michelle M Wassem Muhammad M Dalziel Stuart R SR Freedman Stephen B SB

JAMA network open 20220104 1

<h4>Importance</h4>Severe outcomes among youths with SARS-CoV-2 infections are poorly characterized.<h4>Objective</h4>To estimate the proportion of children with severe outcomes within 14 days of testing positive for SARS-CoV-2 in an emergency department (ED).<h4>Design, setting, and participants</h4>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 infecti ...[more]

PMID: 35015063

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Dataset Information

Outcomes of SARS-CoV-2-Positive Youths Tested in Emergency Departments: The Global PERN-COVID-19 Study.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Outcomes of SARS-CoV-2-Positive Youths Tested in Emergency Departments: The Global PERN-COVID-19 Study.

Similar Datasets

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