COVID-19-related nationwide lockdown did not reduce the reported diagnoses of <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> in Finland

Abstract

<h3>Abstract</h3> <h3>Objective</h3> To characterize the clinical features of children and adolescents hospitalized with SARS-CoV-2 infections and to explore predictors for disease severity. <h3>Design</h3> Nationwide prospective observational cohort study. <h3>Setting</h3> Data collected from 169 out of 351 children’s hospitals in Germany between March 18, 2020 and April 30, 2021 and comparison with the Statutory Notification System. <h3>Participants</h3> 1,501 children and adolescents up to 19 years of age with laboratory confirmed SARS-CoV-2 infections who were admitted to children’s hospitals and subsequently reported to the COVID-19 registry of the German Pediatric Infectious Disease Society (DGPI). <h3>Main outcome measures</h3> Admission to intensive care, in-hospital. <h3>Results</h3> As compared to the information in the statutory notification system, up to 30% of all children and adolescents hospitalized in Germany during the study period were reported to the DGPI registry. Median age was three years (IQR, 0-12), with 36% of reported cases being infants. Although roughly half of patients in the registry were not admitted to the hospital due to their SARS-CoV-2 infection, 72% showed infection-related symptoms during hospitalization. Preexisting comorbidities were present in 28%, most commonly respiratory disorders, followed by neurological, neuromuscular, and cardiovascular diseases. Median length of hospitalization was five days (IQR 3-10). Only 20% of patients received a SARS-CoV-2-related therapy. Infants were less likely to require therapy as compared to older children. Overall, 111 children and adolescents were admitted to intensive care units (ICU). In a fully adjusted model, patient age, trisomy 21, coinfections and primary immunodeficiencies (PID) were significantly associated with intensive care treatment. In a bivariate analysis, pulmonary hypertension, cyanotic heart disease, status post (s/p) cardiac surgery, fatty liver disease, epilepsy and neuromuscular impairment were statistically significant risk factors for ICU admission. <h3>Conclusion</h3> Overall, a small proportion of children and adolescents was hospitalized in Germany during the first year of the pandemic. The majority of patients within our registry was not admitted due to COVID-19 suggesting an overestimation of the disease burden even in hospitalized children. Nevertheless, a large proportion of children and adolescents with confirmed COVID-19 reported in Germany could be captured. This allowed for detailed assessment of overall disease severity and underlying risk factors in our cohort. The main risk factors for COVID-19 disease associated intensive care treatment were older patient age, trisomy 21, PIDs and coinfection at the time of hospitalization. <h3>Trial registration</h3> Registry of hospitalized pediatric patients with SARS-CoV-2 infection (COVID-19), DRKS00021506

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