Study identifies predictors of severe outcomes in children with COVID-19

A new international study offers a clearer picture of the impact of Covid-19 infection and the risk of severe outcomes on young people around the world. 

Professor Stuart Dalziel, study author and Cure Kids Chair of Child Health Research, University of Auckland, says the timing of the research, coinciding with the launch of Covid-19 vaccination of children aged 5 to 11 years in Aotearoa New Zealand, dispels the myth children are being vaccinated solely to protect adults.

“There is a perception that Covid-19 is only a very mild infection in children. However, as the pandemic has progressed, we are seeing greater numbers of children being infected and presenting to hospital worldwide. Unfortunately, for some of these children, Covid-19 results in severe disease,” Professor Dalziel says.

The study followed more than 10,300 children at 41 emergency departments across 10 countries, including New Zealand, Canada and the US.

More than 3,200 children tested positive for Covid-19. Of those, three percent (107) experienced severe outcomes within two weeks of their visit to the emergency department. Severe outcomes included cardiac or cardiovascular complications, such as myocarditis (inflammation of the heart), as well as neurological, respiratory, or infectious problems. In addition, 23 percent (735) were hospitalised for treatment. Four children died. The study was published in JAMA Network Open on 11 January 2022.

“The study sought to quantify the frequency of and risk factors for severe outcomes in children with Covid-19,” says study co-lead Dr Stephen Freedman, a paediatrician and professor at the Cumming School of Medicine, University of Calgary, Canada.

“We found that older age (5 to 18 years), having a pre-existing chronic condition and symptom duration were important risk factors for severe outcomes.”

Researchers also found children deemed healthy at an initial emergency department visit rarely deteriorated significantly after the first visit.

“As New Zealand prepares for the inevitable surge of Covid-19, the study will help emergency doctors triage paediatric patients more efficiently by knowing who has risk factors for severe outcomes and focus care accordingly,” Professor Dalziel says.

The study occurred within the Pediatric Emergency Research Network, a global consortium of the world's major paediatric emergency care research networks, chaired by Professor Dalziel.