389. PediCoViral: Clinical Outcomes of COVID-related Co-viral infections in Children

Abstract

Abstract Background During the earlier phase of the COVID-19 pandemic, published reports demonstrated low rates of COVID co-viral infections. Upon relaxing public health measures, the epidemiology of known respiratory viral pathogens had dramatically shifted as the pandemic evolved. Little is known about the clinical impact of co-viral infections in children post-Omicron wave. This study investigates the clinical outcomes among children, adolescents, and young adults who test positive for SARS-CoV-2 [COVID] alone compared to those with COVID co-viral infection with either RSV or Influenza [Flu] A/B [denoted as COVID+] Methods We conducted a retrospective study of subjects ≤ 21 years of age who tested positive for SAR-CoV-2 presenting to the Children’s Hospital at Montefiore, Bronx, NY from 12/1/2021 to 1/15/2023. Laboratory confirmation was established using a multi-target PCR assay for influenza A/B, RSV, and SARS-CoV-2. The primary outcomes were hospitalization, need for invasive mechanical ventilation (IMV), and mortality. Demographic and patient outcomes were extracted using ATLAS database. Results Among 8307 subjects who tested positive for COVID alone, 8.5% (708) were hospitalized with a mean age of 8.7 years (SD=7.8) while mean age of those with COVID+ was 5.0 years (SD=4.4). Hospitalization rates for COVID alone, COVID+Flu, and COVID+RSV were 6.4%, 32.2%, and 57.7%, respectively (p< 0.001). COVID positive children ≤ 5 years of age with or without a second virus were more likely to be hospitalized than other age group (p< 0.001). When comparing COVID+Flu vs. Flu alone (32.2% vs. 4.3%, p< 0.001) or COVID+RSV vs. RSV alone (57.7% vs. 15.8%, p< 0.001), hospitalization rates were higher for those with COVID co-viral infections. No increase in mortality was observed.Figure 1.Patient Flow ChartTable 1.Patient Demographics and Characteristics*unadjustedTable 2.Clinical outcomes of pediatric patients Conclusion This single center retrospective study demonstrates that SARS-CoV-2 coinfection with RSV or Influenza is associated with increased risk for hospitalization compared to SARS-CoV-2, RSV or influenza alone. Hospitalization rates were higher in younger children. Further studies are needed to identify the mechanisms driving the increased morbidity associated with these coinfections. Disclosures All Authors: No reported disclosures