Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0-17 Years - United States, August 2020-August 2021.

David A Siegel,Craig N Shapiro,Michael Martin,Sapna Bamrah Morris,Pamela Logan,Joyce Dalton,Cria G Perrine,Joy Hsu,Michael Sheppard,Jennifer Adjemian,Elliot Raizes,Hannah E Reses,Elizabeth B Gray,Linda Mattocks,Amitabh B Suthar,Kanta Sircar,Pavithra Natarajan,Eghosa Oyegun,Beth Schweitzer,S Jane Henley,Cheryl R Cornwell,Andrea J Cool,Tegan K Boehmer,B Casey Lyons,Katharina L Van Santen,Georgina Peacock,Karl Soetebier ,Kathleen P Hartnett ,Kimberly A Lochner ,Osatohamwen I Idubor

doi:10.15585/mmwr.mm7036e1

Abstract

Although COVID-19 generally results in milder disease in children and adolescents than in adults, severe illness from COVID-19 can occur in children and adolescents and might require hospitalization and intensive care unit (ICU) support (1-3). It is not known whether the B.1.617.2 (Delta) variant,* which has been the predominant variant of SARS-CoV-2 (the virus that causes COVID-19) in the United States since late June 2021,† causes different clinical outcomes in children and adolescents compared with variants that circulated earlier. To assess trends among children and adolescents, CDC analyzed new COVID-19 cases, emergency department (ED) visits with a COVID-19 diagnosis code, and hospital admissions of patients with confirmed COVID-19 among persons aged 0-17 years during August 1, 2020-August 27, 2021. Since July 2021, after Delta had become the predominant circulating variant, the rate of new COVID-19 cases and COVID-19-related ED visits increased for persons aged 0-4, 5-11, and 12-17 years, and hospital admissions of patients with confirmed COVID-19 increased for persons aged 0-17 years. Among persons aged 0-17 years during the most recent 2-week period (August 14-27, 2021), COVID-19-related ED visits and hospital admissions in the states with the lowest vaccination coverage were 3.4 and 3.7 times that in the states with the highest vaccination coverage, respectively. At selected hospitals, the proportion of COVID-19 patients aged 0-17 years who were admitted to an ICU ranged from 10% to 25% during August 2020-June 2021 and was 20% and 18% during July and August 2021, respectively. Broad, community-wide vaccination of all eligible persons is a critical component of mitigation strategies to protect pediatric populations from SARS-CoV-2 infection and severe COVID-19 illness.

Highlights

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest
Sapna Bamrah Morris serves on the data safety monitoring board for the PaTS COVID Cohort2 Trial (Africa)
No other potential conflicts of interest were disclosed

Summary

Discussion

Among U.S children and adolescents aged 0–17 years, COVID-19 cases and associated ED visits and hospital admissions increased during June 2021–August 2021. During a 2-week period in August 2021, COVID-19–associated ED. §§§ HHS Region 4 includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. Hospital admissions data in this report do not include Georgia. 0–4 yrs bimodal age distribution is consistent with other published data [5]. COVID-19 vaccination coverage quartiles during June–August 2021. B.1.617.2 (Delta) suggest that persons infected with the Delta becomes predominant. SARS-CoV-2 variant for hospitalization [6], it is not clear whether the Delta variant causes more severe illness in adult or pediatric populations. It is possible that increases in COVID-19–related

Delta variant compared with severity for earlier

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