International Analysis of Electronic Health Records of Children and Youth Hospitalized With COVID-19 Infection in 6 Countries

Additional sources of pediatric epidemiological and clinical data are needed to efficiently study COVID-19 in children and youth and inform infection prevention and clinical treatment of pediatric patients. To describe international hospitalization trends and key epidemiological and clinical feature...

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Published in:	JAMA network open 2021-06, Vol.4 (6), p.e2112596-e2112596
Main Authors:	Bourgeois, Florence T, Gutiérrez-Sacristán, Alba, Keller, Mark S, Liu, Molei, Hong, Chuan, Bonzel, Clara-Lea, Tan, Amelia L M, Aronow, Bruce J, Boeker, Martin, Booth, John, Cruz Rojo, Jaime, Devkota, Batsal, García Barrio, Noelia, Gehlenborg, Nils, Geva, Alon, Hanauer, David A, Hutch, Meghan R, Issitt, Richard W, Klann, Jeffrey G, Luo, Yuan, Mandl, Kenneth D, Mao, Chengsheng, Moal, Bertrand, Moshal, Karyn L, Murphy, Shawn N, Neuraz, Antoine, Ngiam, Kee Yuan, Omenn, Gilbert S, Patel, Lav P, Jiménez, Miguel Pedrera, Sebire, Neil J, Balazote, Pablo Serrano, Serret-Larmande, Arnaud, South, Andrew M, Spiridou, Anastasia, Taylor, Deanne M, Tippmann, Patric, Visweswaran, Shyam, Weber, Griffin M, Kohane, Isaac S, Cai, Tianxi, Avillach, Paul
Format:	Article
Language:	eng
Subjects:	Adolescent Child Child, Preschool Children & youth Coronaviruses COVID-19 COVID-19 - epidemiology Electronic Health Records Electronic Health Records - statistics & numerical data Female Global Health Health Informatics Hospitalization Hospitalization - statistics & numerical data Humans Infant Infant, Newborn Infections Laboratories Life Sciences Male Online Only Original Investigation Pandemics Patients Pediatrics Retrospective Studies Santé publique et épidémiologie SARS-CoV-2 Trends
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Summary:	Additional sources of pediatric epidemiological and clinical data are needed to efficiently study COVID-19 in children and youth and inform infection prevention and clinical treatment of pediatric patients. To describe international hospitalization trends and key epidemiological and clinical features of children and youth with COVID-19. This retrospective cohort study included pediatric patients hospitalized between February 2 and October 10, 2020. Patient-level electronic health record (EHR) data were collected across 27 hospitals in France, Germany, Spain, Singapore, the UK, and the US. Patients younger than 21 years who tested positive for COVID-19 and were hospitalized at an institution participating in the Consortium for Clinical Characterization of COVID-19 by EHR were included in the study. Patient characteristics, clinical features, and medication use. There were 347 males (52%; 95% CI, 48.5-55.3) and 324 females (48%; 95% CI, 44.4-51.3) in this study's cohort. There was a bimodal age distribution, with the greatest proportion of patients in the 0- to 2-year (199 patients [30%]) and 12- to 17-year (170 patients [25%]) age range. Trends in hospitalizations for 671 children and youth found discrete surges with variable timing across 6 countries. Data from this cohort mirrored national-level pediatric hospitalization trends for most countries with available data, with peaks in hospitalizations during the initial spring surge occurring within 23 days in the national-level and 4CE data. A total of 27 364 laboratory values for 16 laboratory tests were analyzed, with mean values indicating elevations in markers of inflammation (C-reactive protein, 83 mg/L; 95% CI, 53-112 mg/L; ferritin, 417 ng/mL; 95% CI, 228-607 ng/mL; and procalcitonin, 1.45 ng/mL; 95% CI, 0.13-2.77 ng/mL). Abnormalities in coagulation were also evident (D-dimer, 0.78 ug/mL; 95% CI, 0.35-1.21 ug/mL; and fibrinogen, 477 mg/dL; 95% CI, 385-569 mg/dL). Cardiac troponin, when checked (n = 59), was elevated (0.032 ng/mL; 95% CI, 0.000-0.080 ng/mL). Common complications included cardiac arrhythmias (15.0%; 95% CI, 8.1%-21.7%), viral pneumonia (13.3%; 95% CI, 6.5%-20.1%), and respiratory failure (10.5%; 95% CI, 5.8%-15.3%). Few children were treated with COVID-19-directed medications. This study of EHRs of children and youth hospitalized for COVID-19 in 6 countries demonstrated variability in hospitalization trends across countries and identified common complications and laboratory abnormaliti
ISSN:	2574-3805 2574-3805