Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 14;69(32):1081-1088.
doi: 10.15585/mmwr.mm6932e3.

Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 1-July 25, 2020

Lindsay Kim, Michael Whitaker, Alissa O'Halloran, Anita Kambhampati, Shua J Chai, Arthur Reingold, Isaac Armistead, Breanna Kawasaki, James Meek, Kimberly Yousey-Hindes, Evan J Anderson, Kyle P Openo, Andy Weigel, Patricia Ryan, Maya L Monroe, Kimberly Fox, Sue Kim, Ruth Lynfield, Erica Bye, Sarah Shrum Davis, Chad Smelser, Grant Barney, Nancy L Spina, Nancy M Bennett, Christina B Felsen, Laurie M Billing, Jessica Shiltz, Melissa Sutton, Nicole West, H Keipp Talbot, William Schaffner, Ilene Risk, Andrea Price, Lynnette Brammer, Alicia M Fry, Aron J Hall, Gayle E Langley, Shikha Garg; COVID-NET Surveillance Team
Collaborators, Affiliations

Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 1-July 25, 2020

Lindsay Kim et al. MMWR Morb Mortal Wkly Rep. .

Abstract

Most reported cases of coronavirus disease 2019 (COVID-19) in children aged <18 years appear to be asymptomatic or mild (1). Less is known about severe COVID-19 illness requiring hospitalization in children. During March 1-July 25, 2020, 576 pediatric COVID-19 cases were reported to the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a population-based surveillance system that collects data on laboratory-confirmed COVID-19-associated hospitalizations in 14 states (2,3). Based on these data, the cumulative COVID-19-associated hospitalization rate among children aged <18 years during March 1-July 25, 2020, was 8.0 per 100,000 population, with the highest rate among children aged <2 years (24.8). During March 21-July 25, weekly hospitalization rates steadily increased among children (from 0.1 to 0.4 per 100,000, with a weekly high of 0.7 per 100,000). Overall, Hispanic or Latino (Hispanic) and non-Hispanic black (black) children had higher cumulative rates of COVID-19-associated hospitalizations (16.4 and 10.5 per 100,000, respectively) than did non-Hispanic white (white) children (2.1). Among 208 (36.1%) hospitalized children with complete medical chart reviews, 69 (33.2%) were admitted to an intensive care unit (ICU); 12 of 207 (5.8%) required invasive mechanical ventilation, and one patient died during hospitalization. Although the cumulative rate of pediatric COVID-19-associated hospitalization remains low (8.0 per 100,000 population) compared with that among adults (164.5),* weekly rates increased during the surveillance period, and one in three hospitalized children were admitted to the ICU, similar to the proportion among adults. Continued tracking of SARS-CoV-2 infections among children is important to characterize morbidity and mortality. Reinforcement of prevention efforts is essential in congregate settings that serve children, including childcare centers and schools.

PubMed Disclaimer

Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Evan Anderson reports personal fees from AbbVie, Pfizer and Sanofi Pasteur, and grants from MedImmune, Regeneron, PaxVax, Pfizer, GSK, Merck, Novavax, Sanofi Pasteur, Micron, and Janssen, outside the submitted work. William Schaffner reports personal fees from Pfizer and VBI Vaccines outside the submitted work. No other potential conflicts of interest were disclosed.

Figures

FIGURE 1
FIGURE 1
Cumulative (A) and weekly (B) COVID-19–associated hospitalization rates,† among children aged <18 years, by age group — COVID-NET, 14 states, March 1–July 25, 2020 Abbreviation: COVID-NET = Coronavirus Disease 2019–Associated Hospitalization Surveillance Network. * Number of children in each age group hospitalized with COVID-19 per 100,000 population. † Figure B shows the 3-week moving average of weekly hospitalization rates for children in each age group hospitalized with COVID-19 per 100,000 population. A trend test was conducted using weighted linear regression, where the weight for each week was the inverse of the variance. Trend test overall (<18 years): p-value <0.001. § Counties included in COVID-NET surveillance: California (Alameda, Contra Costa, and San Francisco counties); Colorado (Adams, Arapahoe, Denver, Douglas, and Jefferson counties); Connecticut (New Haven and Middlesex counties); Georgia (Clayton, Cobb, DeKalb, Douglas, Fulton, Gwinnett, Newton, and Rockdale counties); Iowa (one county represented); Maryland (Allegany, Anne Arundel, Baltimore, Baltimore City, Calvert, Caroline, Carroll, Cecil, Charles, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Montgomery, Prince George’s, Queen Anne’s, St. Mary’s, Somerset, Talbot, Washington, Wicomico, and Worcester counties); Michigan (Clinton, Eaton, Genesee, Ingham, and Washtenaw counties); Minnesota (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington counties); New Mexico (Bernalillo, Chaves, Dona Ana, Grant, Luna, San Juan, and Santa Fe counties); New York (Albany, Columbia, Genesee, Greene, Livingston, Monroe, Montgomery, Ontario, Orleans, Rensselaer, Saratoga, Schenectady, Schoharie, Wayne, and Yates counties); Ohio (Delaware, Fairfield, Franklin, Hocking, Licking, Madison, Morrow, Perry, Pickaway, and Union counties); Oregon (Clackamas, Multnomah, and Washington counties); Tennessee (Cheatham, Davidson, Dickson, Robertson, Rutherford, Sumner, Williamson, and Wilson counties); and Utah (Salt Lake County). Data are preliminary, and case counts and rates for recent hospital admissions are subject to lag. As data are received each week, previous case counts and rates are updated accordingly.
FIGURE 2
FIGURE 2
Cumulative COVID-19–associated hospitalization rates among children aged <18 years, by age group and race/ethnicity — COVID-NET, 14 states, March 1–July 25, 2020, Abbreviation: COVID-NET = Coronavirus Disease 2019–Associated Hospitalization Surveillance Network. * Number of children aged <18 years hospitalized with COVID-19 per 100,000 population. † Counties included in COVID-NET surveillance: California (Alameda, Contra Costa, and San Francisco counties); Colorado (Adams, Arapahoe, Denver, Douglas, and Jefferson counties); Connecticut (New Haven and Middlesex counties); Georgia (Clayton, Cobb, DeKalb, Douglas, Fulton, Gwinnett, Newton, and Rockdale counties); Iowa (one county represented); Maryland (Allegany, Anne Arundel, Baltimore, Baltimore City, Calvert, Caroline, Carroll, Cecil, Charles, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Montgomery, Prince George’s, Queen Anne’s, St. Mary’s, Somerset, Talbot, Washington, Wicomico, and Worcester counties); Michigan (Clinton, Eaton, Genesee, Ingham, and Washtenaw counties); Minnesota (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington counties); New Mexico (Bernalillo, Chaves, Dona Ana, Grant, Luna, San Juan, and Santa Fe counties); New York (Albany, Columbia, Genesee, Greene, Livingston, Monroe, Montgomery, Ontario, Orleans, Rensselaer, Saratoga, Schenectady, Schoharie, Wayne, and Yates counties); Ohio (Delaware, Fairfield, Franklin, Hocking, Licking, Madison, Morrow, Perry, Pickaway, and Union counties); Oregon (Clackamas, Multnomah, and Washington counties); Tennessee (Cheatham, Davidson, Dickson, Robertson, Rutherford, Sumner, Williamson, and Wilson counties); and Utah (Salt Lake County). § Data are preliminary, and case counts and rates for recent hospital admissions are subject to lag. As data are received each week, prior case counts and rates are updated accordingly. As of July 25, 2020, 50 (8.7%) of 576 pediatric hospitalized cases were missing data on race and ethnicity. Rates are not shown among non-Hispanic Asian or Pacific Islanders and non-Hispanic American Indian/Alaska Natives because of small case counts, leading to unstable estimates. All non-Hispanic American Indian/Alaska Native hospitalized children were aged 5–17 years.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. He J, Guo Y, Mao R, Zhang J. Proportion of asymptomatic coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. J Med Virol 2020;jmv.26326. 10.1002/jmv.26326 - DOI - PMC - PubMed
    1. Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 states, March 1–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:458–64. 10.15585/mmwr.mm6915e3 - DOI - PMC - PubMed
    1. Kim L, Garg S, O’Halloran A, et al. Risk factors for intensive care unit admission and in-hospital mortality among hospitalized adults identified through the U.S. coronavirus disease 2019 (COVID-19)-associated hospitalization surveillance network (COVID-NET). Clin Infect Dis 2020;ciaa1012. 10.1093/cid/ciaa1012 - DOI - PMC - PubMed
    1. Martinez DA, Hinson JS, Klein EY, et al. SARS-CoV-2 positivity rate for Latinos in the Baltimore-Washington, DC region. JAMA 2020;324:392–5. 10.1001/jama.2020.11374 - DOI - PMC - PubMed
    1. Sachedina N, Donaldson LJ. Paediatric mortality related to pandemic influenza A H1N1 infection in England: an observational population-based study. Lancet 2010;376:1846–52. 10.1016/S0140-6736(10)61195-6 - DOI - PubMed

MeSH terms