Children, teens, and young adults have a greater risk for severe complications from COVID-19 than previously thought, a new study shows.

The study, the first to describe the characteristics of seriously ill pediatric COVID-19 patients in North America, also shows kids with underlying health conditions have an even greater risk.

“The idea that COVID-19 is sparing of young people is just false,” says coauthor Lawrence C. Kleinman, professor and vice chair for academic development and chief of the department of pediatrics’ division of population health, quality, and implementation science at Rutgers University’s Robert Wood Johnson Medical School.

“While children are more likely to get very sick if they have other chronic conditions, including obesity, it is important to note that children without chronic illness are also at risk. Parents need to continue to take the virus seriously.”

The study followed 48 children and young adults—from newborns to 21 years old—admitted to pediatric intensive care units (PICUs) in the United States and Canada for COVID-19 in March and April.

More than 80% had chronic underlying conditions, such as immune suppression, obesity, diabetes, seizures, or chronic lung disease. Of those, 40% depended on technological support due to developmental delays or genetic anomalies. More than 20% experienced failure of two or more organ systems due to COVID-19, and nearly 40% required a breathing tube and ventilator.

At the end of the follow-up period, nearly 33% of the children remained hospitalized due to COVID-19, with three still requiring ventilator support and one on life support. Two of the children admitted during the three-week study period died.

“This study provides a baseline understanding of the early disease burden of COVID-19 in pediatric patients,” says Hariprem Rajasekhar, a pediatric intensivist involved with the study. “The findings confirm that this emerging disease was already widespread in March and that it is not universally benign among children.”

The researchers say they are “cautiously encouraged” by hospital outcomes for the children studied, citing the 4.2% mortality rate for PICU patients compared with published mortality rates of up to 62% among adults admitted to ICUs, as well as lower incidences of respiratory failure.

Doctors in the New York metropolitan area are seeing what appears to be a new COVID-related syndrome in children, Kleinman says.

“Although our data collection for this study has ended, we continue to develop collaborations with colleagues in our region and across the country to try to understand these more severe complications,” he says, citing concerns such as heart failure and the Kawasaki disease-like condition termed pediatric multi-system inflammatory syndrome as examples.

The study appears in JAMA Pediatrics.

Source: Rutgers University

Original Study DOI: 10.1001/jamapediatrics.2020.1948