81 - Children and COVID-19 in Colorado: The Children’s Hospital Colorado Experience

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that causes coronavirus disease of 2019 (COVID-19) and has been reported in > 98,000 children in the U.S (5% of reported cases) as of early June 2020. Most published literature focuses on adults with COVID-19, but little is understood on the impact of SARS-CoV-2 in children. We created a database for children with COVID-19 at Children’s Hospital Colorado (CHCO), a large tertiary care pediatric hospital, to better understand the epidemiology and clinical outcomes of this disease in children.

Methods: We retrospectively reviewed the medical records of all pediatric and youth patients with positive SARS-CoV-2 PCR test results from March-May 2020. Univariate logistic regression models were used to identify predictors of hospital admission, need for critical care, and need for respiratory support among symptomatic patients, with p-values < 0.05 considered statistically significant.

Results: We identified 246 patients with SARS-CoV-2 (age range: 17 days-25 years). We noted a Hispanic predominance with 68% of all patients with SARS-CoV-2 identifying as Hispanic or Latino, compared to 29% among all CHCO visits in 2019 (Figure 1). The most common symptoms at presentation were fever, cough, or shortness of breath in 94% of symptomatic patients. Sixty-eight patients (28%) were admitted, of which 7 (10%) required admission to the pediatric intensive care unit (PICU) for symptomatic COVID-19 disease (Figure 2). Age 0-3 months, certain symptoms at presentation, and several types of underlying medical conditions were predictors for both hospital admission and need for respiratory support (Figure 3). Initial and peak C-reactive protein (CRP) values were predictors for PICU admission with median peaks of 24.8mg/dL vs. 2.0mg/dL among PICU vs. non-PICU patients (OR 1.27, p=0.004).Figure 1: Ethnicity of Children with COVID-19 versus All Children's Hospital Colorado (CHCO) Patients in 2019
Figure 2: Summary of CHCO Patients with SARS-CoV-2
Figure 3: Predictors for Admission and Respiratory Support Requirement in CHCO Patients with SARS-CoV-2


Conclusion: There is a wide spectrum of illness in children with SARS-CoV-2, ranging from asymptomatic to critical illness. Hispanic ethnicity was disproportionately represented in our cohort, which requires further evaluation. We found that young age, comorbid conditions, and CRP appear to be risk factors for severe disease in children.

Presenting Author(s)

• 

  Kelly E. Graff, MD

  Fellow
  Children's Hospital Colorado, University of Colorado School of Medicine
  Aurora, Colorado

  Disclosure: BioFire Diagnostics, LLC (Grant/Research Support)

  Slides Slides and Audio

Co-Author(s)

• LS

  Lori Silveira, PhD

  Assistant Professor
  University of Colorado
  Aurora, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• JJ

  Jane Jarjour, MD

  Resident
  Children's Hospital Colorado, University of Colorado School of Medicine
  Aurora, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• SC

  Shane Curran-Hays, MS

  Professional Research Assistant
  Children's Hospital Colorado
  Aurora, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• LC

  Lauren Carpenter, n/a

  Medical Student
  University of Colorado School of Medicine
  Aurora, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• KP

  Kasey Pickard, n/a

  Medical Student
  University of Colorado School of Medicine
  Aurora, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• MM

  Michael Mattiucci, MD

  Resident
  Children's Hospital Colorado, University of Colorado School of Medicine
  Denver, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• CS

  Christiana Smith-Anderson, MD, MSc

  Assistant Professor
  University of Colorado School of Medicine
  Aurora, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• LA

  Lisa Abuogi, MD, MS

  Associate Professor
  University of Colorado
  Denver, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.