While the risk factors for hospitalisation and poor outcomes are well documented in adults, less is known about the clinical factors associated with Covid-19 disease severity in children. American researchers have now determined risk factors that include older age and chronic comorbidities are associated with severe disease and hospitalisation of children.
Little is known about the clinical factors associated with Covid-19 disease severity in children and adolescents. In a bid to mitigate the risk of children developing severe Covid-19 disease, a group of physicians at Monroe Carell Jr. Children’s Hospital in Vanderbilt, Tennessee, studied data from 45 children’s hospitals around the United States.
The study, published on Wednesday 15 September, included 20 000 patients.
It determined factors associated with severe Covid-19-related illness include older age and chronic comorbidities such as obesity, diabetes and neurological conditions, among others.
Lead author and assistant paediatric professor James Antoon notes that this was one of the largest studies of children with Covid-19 in the US.
He said, “Given the recent, concerning increases in Covid cases nationwide [United States] and the fact that the vast majority of children remain unvaccinated and susceptible, these findings should be taken into account when considering preventive strategies in schools and planning vaccinations when available for children less than 12 years of age.”
Prioritising high-risk children
The study, called “Factors Associated with Covid-19 Disease Severity in U.S. Children,” was published in the Journal of Hospital Medicine.
“These factors help identify vulnerable children who are most likely to require hospitalisation or develop severe Covid-19 disease.”
“Our findings also highlight children who should be prioritised for Covid-19 vaccines when approved by the FDA.”
The retrospective cohort study noted that approximately one out of every four children admitted to the hospital with Covid-19, developed severe disease and required ICU care during April and September 2020.
“Some children are at increased risk for more severe disease and many of them are not yet eligible for vaccination against Covid.
“With schools opening and some already in session, these children need to be protected by vaccinating as many people as possible while also using practical strategies to limit spread, such as masking, distancing and ventilation.”
Child vaccination in Mzansi
In Mzansi the South African Health Products Regulatory Authority (SAHPRA) approved the use of the Pfizer vaccine for children on Friday 10 September, making children in the 12 to 17 year age bracket eligible to get their jab.
At the same time, Sinovac had announced its trial vaccination of some 2000 South African kids.
The first child was inoculated on 10 September at the Sefako Makgatho Health Sciences University.
How the rest of the world is handling child vaccinations
Europe: UK children aged 12 to 15 are set to get the Covid jab following advice from the United Kingdom’s chief medical officers.
Denmark and Spain have both vaccinated child populations aged 12 to 19 with at least a single dose. France, too, has administered 66% of single jabs to its 12 to 17-year-old population.
United States: According to the BBC, US and Canadian regulators were the first to approve the Pfizer jab for children 12 years and older in May. By July, 42% of the population between 12 and 17 years old had received their first shot and 32% had received a second shot of either Pfizer’s or Moderna’s vaccine.
Asia: In China, officials set a target to vaccinate 80% of the population. The vaccination rollout for children aged three to 17 began in June with drug producer Sinovac, making it the first country to approve jabs for toddlers.
August saw India’s drug regulator granted emergency use for a new vaccine developed by local pharmaceutical company Zydus Cadila in children 12 and older. The jab is administered in three separate doses using a needle-free applicator.