(P-577) Clinical Characteristics of Pediatric Patients Hospitalized with COVID-19 in an Electronic Health Record Database

Background: There are limited data on the clinical characteristics of pediatric patients hospitalized with COVID-19.

Objectives: To describe the baseline comorbidities, symptoms, diagnoses, laboratory results, and treatments among children and adolescents hospitalized with COVID-19 in the US.

Methods: Pediatric patients (age ≤ 22 years) with COVID-19 were identified in the Optum COVID-19 electronic health record (EHR) database between January 2020 and November 2020. Confirmation of COVID-19 infection was based on presence of ICD-10-CM diagnosis code U07.1 and/or a positive SARS-CoV-2 viral test. Hospitalizations were identified by presence of an inpatient healthcare encounter. Demographic characteristics, baseline comorbidities, laboratory results, symptoms, diagnoses, and treatments during inpatient stay were assessed.

Results: We identified 56,890 patients ≤ 22 years of age with confirmed COVID-19 infection during the study period. Of these, 1,863 patients (64.4% female; 50.0% Caucasian, 18.8% African American) were hospitalized: 6.8% age < 1 year, 8.8% age 1 – 4, 8.2% age 5 – 11, 16.7% age 12 – 17, and 59.4% age 18 – 22. The most common baseline comorbidities were obesity (16.2%), asthma (15.2%), kidney disease (7.3%), cancer (5.3%), and neurologic disorders (5.3%). Fever (17%), nausea/vomiting (7.9%), and abdominal pain (7.1%) were the most prevalent symptoms recorded. During hospitalization, the most frequent diagnoses observed were pneumonia (16.8%), acute respiratory failure (11.9%), and sepsis (11.9%). Multisystem inflammatory syndrome was observed in 3.0% of patients. Common treatments received included antibacterials (56.0%), anticoagulants (37.7%), and corticosteroids (28.2%). Remdesivir was received by 4.6% of patients and chloroquine/hydroxycholorquine by 3.5%. Elevated markers of inflammation and coagulation were observed, including 25.6% of patients with C-reactive protein (CRP) > 10 mg/L, 13.7% with lactate dehydrogenase > 280 U/L, and 11.1% with D-dimer (DDU) > 250 ng/mL. Critical care was received by 15.2% of hospitalized pediatric patients, mechanical ventilation by 6.1%, and 1% of patients died.

Conclusions: Results from this large US cohort of pediatric patients hospitalized with COVID-19 indicate that children and adolescents have relatively low prevalence of symptoms, diagnoses, and elevated laboratory values. A small subset of patients with multisystem inflammatory syndrome were identified; given the seriousness of this complication, further investigation of this subgroup is warranted.