Epidemiology of 7375 children and adolescents hospitalized with COVID-19 in Germany, reported via a prospective, nationwide surveillance study in 2020–2022
Maren Doenhardt, Markus Hufnagel, Natalie Diffloth, Johannes Hübner, René Mauer, Dominik T. Schneider, Arne Simon, Tobias Tenenbaum, Andreas Trotter, Jakob Armann, Reinhard Berner, The DGPI COVID-19 working group, Aischa Abuleed, Michal Achenbach, Grazyna Adamiak-Brych, Martina Aderhold, Sandra Akanbi, Madaa Akmeinasi, Norbert Albers, Louisa Ammann-Schnell, Kristin M. Anders, Theresa Andree, J P Anhalt, Nils Apel, Stefan Arens, Christoph Aring, Caroline Armbruster, Inken Arnold, Thomas R. Austgen, Igor Bachmat, Lena Balles, Arne Baltaci, Theresa Baranowski, Sylvia Barth, Stefan Barth, María Paula Bateman Castrillón, Susanne Baumann, Lisa Baumbach, Boris W. Becker, Angelina Beer, Gerald Beier, Christiane Bell, Antigoni Bellou, Stephanie Bentz, Josephine Berens, Elisabeth Berger, Simon Berzel, Julia Bley, Helga Blumberg, Stefanie Blume, Kai Böckenholt, A Böckmann, Sebastian Bode, Julie Boever, Leonie Böhm, Henning Böhme, Carsten Bölke, Monika-Maria Borchers, Hans Martin Bosse, M. Böswald, Katharina Botschen, Franka Böttger, Sandra Braun, Britta Brenner, Folke Brinkmann, Beate Bruggmoser, Jürgen Brunner, Florian Bucher, Laura Buchtala, Jörg Budde, Reinhard Bullmann, Bernhard Bungert, Dorothea Büsdorf, Lisa Cardellini, Chiara Cattaneo, Cho‐Ming Chao, Laura Chaparro, Claus Christians, K. Cremer, Gordana Cvetanovic, Alina Czwienzek, Madura Daluwatta, Gideon de Sousa, Metin Degirmenci, Fenja Dejas, Janne Deutschmann, Ute Deutz, Iryna Dobrianska, Katharina Döhring, Helena Donath, Arne Dresen, Svenja Dreßen, M Drozdek, Jens Dubenhorst, Max Dunker, Heinrich Eberhardt, Franziska Ebert, Hannah Echelmeyer, Kerstin Ehrentraut, Christoph Ehrsam
Abstract
By means of a nationwide, prospective, multicenter, observational cohort registry collecting data on 7375 patients with laboratory-confirmed SARS-CoV-2 admitted to children's hospitals in Germany, March 2020-November 2022, our study assessed the clinical features of children and adolescents hospitalized due to SARS-CoV-2, evaluated which of these patients might be at highest risk for severe COVID-19, and identified underlying risk factors. Outcomes tracked included: symptomatic infection, case fatality, sequelae at discharge and severe disease. Among reported cases, median age was one year, with 42% being infants. Half were admitted for reasons other than SARS-CoV-2. In 27%, preexisting comorbidities were present, most frequently obesity, neurological/neuromuscular disorders, premature birth, and respiratory, cardiovascular or gastrointestinal diseases. 3.0% of cases were admitted to ICU, but ICU admission rates varied as different SARS-CoV-2 variants gained prevalence. Main risk factors linked to ICU admission due to COVID-19 were: patient age (> 12 and 1-4 years old), obesity, neurological/neuromuscular diseases, Trisomy 21 or other genetic syndromes, and coinfections at time of hospitalization. With Omicron, the group at highest risk shifted to 1-4-year-olds. For both health care providers and the general public, understanding risk factors for severe disease is critical to informing decisions about risk-reduction measures, including vaccination and masking guidelines.