Frequency, Characteristics and Complications of COVID-19 in Hospitalized Infants.

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DOI: 10.1097/INF.0000000000003435; PMCID: PMC8828316


Background: Previous studies of severe acute respiratory syndrome coronavirus 2 infection in infants have incompletely characterized factors associated with severe illness or focused on infants born to mothers with coronavirus disease 2019 (COVID-19). Here we highlight demographics, clinical characteristics and laboratory values that differ between infants with and without severe acute COVID-19.

Methods: Active surveillance was performed by the Overcoming COVID-19 network to identify children and adolescents with severe acute respiratory syndrome coronavirus 2-related illness hospitalized at 62 sites in 31 states from March 15 to December 27, 2020. We analyzed patients >7 days to <1 year old hospitalized with symptomatic acute COVID-19.

Results: We report 232 infants >7 days to <1 year of age hospitalized with acute symptomatic COVID-19 from 37 US hospitals in our cohort from March 15 to December 27, 2020. Among 630 cases of severe COVID-19 in patients >7 days to <18 years old, 128 (20.3%) were infants. In infants with severe illness from the entire study period, the median age was 2 months, 66% were from racial and ethnic minority groups, 66% were previously healthy, 73% had respiratory complications, 13% received mechanical ventilation and <1% died.

Conclusions: Infants accounted for over a fifth of children <18 years of age hospitalized for severe acute COVID-19, commonly manifesting with respiratory symptoms and complications. Although most infants hospitalized with COVID-19 did not suffer significant complications, longer term outcomes remain unclear. Notably, 75% of infants with severe disease were <6 months of age in this cohort study period, which predated maternal COVID-19 vaccination, underscoring the importance of maternal vaccination for COVID-19 in protecting the mother and infant.

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The Pediatric infectious disease journal





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MeSH Keywords

Adolescent; COVID-19; Child; Child, Hospitalized; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Pandemics; Pregnancy; Pregnancy Complications, Infectious; SARS-CoV-2; United States


COVID-19; Hospitalized Child; Vertical Infectious Disease Transmission; Pandemics; Pregnancy; Infectious Pregnancy Complications; SARS-CoV-2; United States

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