Which Kids With COVID Will Get Very Sick?

SATURDAY, Nov. 21, 2020 -- Scientists have identified symptoms that may predict the severity of COVID-19 in children.

According to the researchers, children with respiratory disease and those with multisystem inflammatory syndrome (a rare but serious condition linked with COVID-19) have the most severe illness.

"Much of the discussion to date around COVID-19 suggests that children don't typically suffer serious illness," said researcher Dr. Danielle Fernandes, an attending physician in the division of hospital medicine at Children's Hospital at Montefiore, in New York City.

"Our study shows that children with COVID-19, like adults, can experience symptoms ranging from mild to severe, and tragically, children can die from the disease," Fernandes said in a hospital news release.

For the study, the researchers looked at nearly 300 children hospitalized with COVID-19. Half of the kids had respiratory illness with symptoms including cough, wheezing, sore throat and difficulty breathing.

The others were divided between children who had multisystem inflammatory syndrome and those with a range of symptoms, including gastrointestinal issues and fever.

Children with multisystem inflammatory syndrome were most likely to need intensive care, but only those with respiratory illness died from COVID-19, the study authors said.

Among the COVID-19 patients in this study, race or ethnicity did not influence how the children fared after being hospitalized, the findings showed.

The researchers also found:

• Obese children and kids with low oxygen levels were more likely to have severe respiratory disease and require intensive care.
• One in five children with severe respiratory disease needed intubation and mechanical ventilation.
• Children with lower white blood cells, and those with higher levels of the inflammation marker C-reactive protein, were more likely to have severe multisystem inflammatory syndrome.
• Children with multisystem inflammatory syndrome were more likely to be Black.

"We hope that pediatric providers will use these warning signs to predict which children may need enhanced monitoring and treatment that could prevent them from becoming severely ill or dying," Fernandes said.

The report was published recently in the Journal of Pediatrics.

Posted: November 2020