Comparison of Influenza and COVID-19-Associated Hospitalizations Among Children Younger Than 18 Years Old in the United States: FluSurv-NET (October-April 2017-2021) and COVID-NET (October 2020-September 2021)

• Type of Material: Article
• Authors: Miranda J Delahoy, Centers for Disease Control and Prevention, Atlanta; Dawud Ujamaa, Centers for Disease Control and Prevention, Atlanta; Christopher A Taylor, Centers for Disease Control and Prevention, Atlanta; Charisse Cummings, Centers for Disease Control and Prevention, Atlanta; Onika Anglin, Centers for Disease Control and Prevention, Atlanta; Rachel Holstein, Centers for Disease Control and Prevention, Atlanta; Jennifer Milucky, Centers for Disease Control and Prevention, Atlanta; Alissa O'Halloran, Centers for Disease Control and Prevention, Atlanta; Kadam Patel, Centers for Disease Control and Prevention, Atlanta; Huong Pham, Centers for Disease Control and Prevention, Atlanta; Michael Whitaker, Centers for Disease Control and Prevention, Atlanta; Arthur Reingold, California Emerging Infections Program; Shua J Chai, California Emerging Infections Program; Nisha B Alden, Colorado Department of Public Health and Environment; Breanna Kawasaki, Colorado Department of Public Health and Environment; James Meek, Yale School of Public Health; Kimberly Yousey-Hindes, Yale School of Public Health; Evan Anderson, Emory University; Kyle P Openo, Emory University; Andy Weigel, Iowa Department of Health; Kenzie Teno, Iowa Department of Health; Libby Reeg, Michigan Department of Health and Human Services; Lauren Leegwater, Michigan Department of Health and Human Services; Ruth Lynfield, Minnesota Department of Health, Saint Paul; Melissa McMahon, Minnesota Department of Health, Saint Paul; Susan Ropp, New Mexico Department of Health; Dominic Rudin, New Mexico Department of Health; Alison Muse, New York State Department of Health; Nancy Spina, New York State Department of Health; Nancy M Bennett, University of Rochester; Kevin Popham, University of Rochester; Laurie M Billing, Ohio Department of Health; Eli Shiltz, Ohio Department of Health; Melissa Sutton, Oregon Health Authority; Ann Thomas, Oregon Health Authority; William Schaffner, Vanderbilt University; Keipp H Talbot, Vanderbilt University; Melanie T Crossland, Salt Lake County Health Department; Keegan McCaffrey, Utah Department of Health; Aron J Hall, Centers for Disease Control and Prevention, Atlanta; Erin Burns, Centers for Disease Control and Prevention, Atlanta; Meredith McMorrow, Centers for Disease Control and Prevention, Atlanta; Carrie Reed, Emory University; Fiona Havers, Emory University; Shikha Garg, Centers for Disease Control and Prevention, Atlanta
• Language: English
• Date: 2022-05-20
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1093/cid/ciac388
• Title of Journal or Parent Work: CLINICAL INFECTIOUS DISEASES
• Keywords: COVID-19; PREVENTION; Infectious Diseases; Immunology; SEASONAL INFLUENZA; DEATHS; Life Sciences & Biomedicine; influenza; Science & Technology; BURDEN; children; SARS-CoV-2; Microbiology; ADOLESCENTS; surveillance

Abstract

BACKGROUND: Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. METHODS: Influenza and COVID-19-associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, two population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19-associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (October 1, 2020-September 30, 2021) was compared to influenza-associated hospitalization rates during the 2017-18 through 2019-20 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. RESULTS: Among children <18 years old, the COVID-19-associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017-18 (33.5), 2018-19 (33.8), and 2019-20 (41.7). The COVID-19-associated hospitalization rate was higher among adolescents 12-17 years old (COVID-19: 59.9; influenza range: 12.2-14.1), but similar or lower among children 5-11 (COVID-19: 25.0; influenza range: 24.3-31.7) and 0-4 (COVID-19: 66.8; influenza range: 70.9-91.5) years old. Among children <18 years old, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; p < 0.01). Pediatric deaths were uncommon during both COVID-19- and influenza-associated hospitalizations (0.7% vs 0.5%; p = 0.28). CONCLUSIONS: In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19-associated hospitalization rate during 2020-2021 was higher among adolescents and similar or lower among children <12 years old compared with influenza during the three seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses.