Abstract
Background: Coronavirus disease 2019 (COVID-19) is usually less severe in children compared to adults. This study describes detailed clinical characteristics, treatment and outcomes of children with laboratory-confirmed COVID-19 in a non-hospitalised and hospitalised setting and quantifies factors associated with admission to hospital and intensive care unit in children with SARS-CoV-2 infection on a nationwide level.Methods: Data were collected through the Swiss Paediatric Surveillance Unit from children Findings: In total, 678 children were included. The median age was 12.2 (IQR 5.0 – 14.6) years, 316 (47%) were female and 106 (16%) had comorbidities. Overall, 126 (18.6%) children were hospitalised of whom 16 (12.7%) required ICU admission. Comorbidities were the only factor associated with hospital admission in a multivariable regression analysis (odds ratio 3.23, 95%CI 1.89 to 5.50; p-value Interpretation: This study confirms that COVID-19 is mostly a mild disease in children. Fever, rash, and comorbidities are associated with higher admission rates. Continuous observation is necessary to further understand paediatric COVID-19, guide therapy and evaluate the necessity for vaccination in children.Funding: The study is supported by the Swiss Federal Office of Public Health and has received grants from the Swiss Society of Paediatrics and the Paediatric Infectious Disease Group of Switzerland.Declaration of Interest: None to declare.Ethical Approval: The study has received ethical approval by the Ethikkommission Nordwest- undZentralschweiz (EKNZ 2020-01130).
Highlights
This study confirms that COVID-19 is mostly a mild disease in children
The disease severity is often milder in children, paediatric patients may develop severe disease requiring admission to intensive care unit (ICU) and may very rarely die from COVID-19.6–8 children presenting with a delayed inflammatory disease called ‘paediatric inflammatory multisystem syndrome-temporally associated with SARS-CoV-2 (PIMS-TS)’ or ’multisystem inflammatory syndrome in children (MIS-C)’ have been reported.[7,9,10,11,12,13,14,15]
The age of the children ranged from 7 days to 17.9 years with a median of 12.2 years (interquartile range (IQR) 5.0 – 14.6) (Table 1)
Summary
The data on SARS-CoV-2 infection in children and adolescents either come from non-admitted children with limited clinical information or from hospitalised children only. This limits the knowledge in paediatric COVID-19 on factors associated with admission including clinical presentation and risk factors such as age, sex, or comorbidities. This nationwide study presents the first epidemiological data from active surveillance of SARS-CoV-2 infections in non-hospitalised and hospitalised children in Switzerland
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