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Master of Public Health

Frequency, Characteristics and Complications of COVID-19 in Hospitalized Infants

AUTHORS

Hobbs CV , Woodworth K , Young CC , Jackson AM , Newhams MM , Dapul H , Maamari M , Hall MW , Maddux AB , Singh AR , Schuster JE , Rowan CM , Fitzgerald JC , Irby K , Kong M , Mack EH , Staat MA , Cvijanovich NZ , Bembea MM , Coates BM , Halasa NB , Walker TC , McLaughlin GE , Babbitt CJ , Nofziger RA , Loftis LL , Bradford TT , Campbell AP , Patel MM , Randolph AG , , . The Pediatric infectious disease journal. 2021 12 21; ().

ABSTRACT

BACKGROUND: Previous studies of severe acute respiratory syndrome coronavirus 2 infection in infants have incompletely characterized factors associated with severe illness or focused on infants born to mothers with coronavirus disease 2019 (COVID-19). Here we highlight demographics, clinical characteristics and laboratory values that differ between infants with and without severe acute COVID-19.

METHODS: Active surveillance was performed by the Overcoming COVID-19 network to identify children and adolescents with severe acute respiratory syndrome coronavirus 2-related illness hospitalized at 62 sites in 31 states from March 15 to December 27, 2020. We analyzed patients aged >7 days to <1 year hospitalized with symptomatic acute COVID-19.

RESULTS: We report 232 infants aged >7 days to <1 year hospitalized with acute symptomatic COVID-19 from 37 US hospitals in our cohort from March 15 to December 27, 2020. Among 630 cases of severe COVID-19 in patients aged >7 days to <18 years, 128 (20.3%) were infants. In infants with severe illness from the entire study period, the median age was 2 months, 66% were from racial and ethnic minority groups, 66% were previously healthy, 73% had respiratory complications, 13% received mechanical ventilation and <1% died.

CONCLUSIONS: Infants accounted for over a fifth of children aged <18 years hospitalized for severe acute COVID-19, commonly manifesting with respiratory symptoms and complications. Although most infants hospitalized with COVID-19 did not suffer significant complications, longer term outcomes remain unclear. Notably, 75% of infants with severe disease were <6 months of age in this cohort study period, which predated maternal COVID-19 vaccination, underscoring the importance of maternal vaccination for COVID-19 in protecting the mother and infant.

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