Written by Kimiko Dunbar
Spoon Feed
Children with underlying conditions (i.e. chronic lung disease, cardiovascular disease, diabetes, neurologic disorders) are more likely to have severe outcomes with COVID-19 infection, especially if not up to date with vaccination.
Turns out, vaccines work
While most COVID-19 infections in kids are mild, children can have severe outcomes from COVID-19, including death. The majority of prior data regarding risk factors for severe disease were obtained early in the pandemic. Disease epidemiology has changed since the onset of COVID-19, including access to immunization, calling for updated data. This population-based surveillance study examined risk factors for severe COVID-19 among 2,490 hospitalized U.S. children aged ≥6 months from 4/2022–10/2024. Of these, 59% had ≥1 underlying condition and fewer than 5% were up-to-date with COVID-19 vaccination. Severe outcomes were significantly associated with chronic lung disease (aRR 1.5–1.9), cardiovascular disease (aRR 1.4), diabetes (aRR 1.5), and neurologic disorders (aRR 1.4). Limitations include potential under-ascertainment and limited generalizability. Findings underscore the urgent need to improve pediatric COVID-19 vaccination coverage.
How does this change my practice?
This study has changed the way I will counsel about COVID-19 vaccination, especially in those with underlying medical conditions. Conversations regarding COVID vaccination seemed to have waned over the past several years, replaced by conversations regarding RSV immunization. When faced with a patient with underlying medical conditions, I will be more thoughtful around counseling. On the wards, it’s worth paying a bit more attention to our medically complex admitted with COVID, as they have the potential to get sick(er).
Source
Hospitalization for COVID-19 and Risk Factors for Severe Disease Among Children: 2022-2024. Pediatrics. 2025 Jul 3. doi: 10.1542/peds.2025-072788. Epub ahead of print. PMID: 40604359
