Hospitalization rates among children with COVID-19 comparable to those with the flu: study

TORONTO — A new study suggests that children with COVID-19 do not have a higher chance of developing serious health complications that require hospitalization compared to kids with seasonal influenza.

U.S. researchers have found no “statistically significant differences” in the rates of hospitalization, admission to the intensive care unit (ICU) and mechanical ventilator use between children with the coronavirus and those with the flu.

While there is little published data directly comparing children with COVID-19 to those with the flu, researchers at the Children’s National Hospital in Washington, D.C. conducted a retrospective cohort study of patients in the two groups.

Their findings were published Tuesday in the medical journal JAMA Network Open.

Unexpectedly, researchers also found that more patients with COVID-19 than those with seasonal influenza reported fever, cough, diarrhea or vomiting, headache, body ache and chest pain at the time of diagnosis.

The study’s principal investigator and director of Infection Control and Epidemiology at Children’s National, Dr. Xiaoyan Song, says this is a significant finding.

“It’s a good cue from a prevention and planning perspective,” Song said in a press release. “We always emphasize early recognition and early isolation with COVID. Having a clinical picture in mind will assist clinicians as they diagnose patients with symptoms of the coronavirus.”

The study looked at 315 children who were diagnosed with COVID-19 between March 25 and May 15 in comparison to 1,402 children who were diagnosed with seasonal influenza between Oct. 1, 2019 and June 6, 2020 at Children’s National.

Of the patients studied who contracted COVID-19, 17 per cent were hospitalized including nearly six per cent who were admitted to the ICU and three per cent who received mechanical ventilator treatment.

Among those who tested positive for influenza, 21 per cent were hospitalized, with seven per cent admitted to the ICU, and almost two per cent receiving mechanical ventilator support.

The data showed a slight difference in the age of children hospitalized with COVID-19 compared to those hospitalized with the flu. Patients with the coronavirus had a median age of 9.7 years while those hospitalized with influenza had a median age of 4.2 years.

In both groups, males accounted for 52 per cent of positive tests. Both groups also showed that fever was the most often reported symptom at the time of diagnosis, followed by a cough.

More patients hospitalized with COVID-19 than those with seasonal influenza also reported sore throat or congestion (22 per cent versus 20 per cent) and shortness of breath (30 per cent versus 20 per cent), but the differences were “not statistically significant,” according to the study.

The study noted that asymptomatic patients who tested positive for COVID-19 during the pre-procedural screening process were excluded from the study.

During the study, researchers said they saw an “abrupt decline” in influenza cases at the Children’s National Hospital after schools closed in mid-March and stay-at-home orders were issued to help limit the spread of COVID-19.

As students return to the classroom in the coming days, Song said the research team’s next steps are to take a closer look at the impact of school closures on the spread of COVID-19 among children.

“We want to assess the quantitative impact of school closures so we can determine at what point the cost of closing schools and staying at home outweighs the benefit of reducing transmission of COVID-19 and burdens on the health care system,” Song said in the release.

While the study suggests COVID-19 may not be worse for children than the flu, researchers caution that it is also not any better either.

“We’re learning new and valuable things about this virus each day, which in turn improves care. The collision of the flu and COVID-19 this fall could mean an increase in pediatric hospitalizations,” Song said.

“That’s why it’s important to get your flu shot, because it can help take at least one respiratory virus out of circulation.”


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