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Am J Perinatol 2024; 41(S 01): e2727-e2734
DOI: 10.1055/a-2149-8810
Original Article

Nationwide Analysis of the Outcomes and Mortality of Hospitalized Infants with Concomitant Diagnosis of COVID-19

Parvathy Krishnan 
1   Department of Neonatal-Perinatal Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York
,
Aaqib Malik
2   Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
,
Ameesh Isath
2   Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
,
Dhrubajyoti Bandyopadhyay
2   Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
,
Akshay Goel
2   Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
,
Lance Parton
1   Department of Neonatal-Perinatal Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York
,
Praveen Chandrasekharan
3   Department of Neonatal-Perinatal Medicine, University at Buffalo, Kaleida Health, UBMD Pediatrics, Buffalo, New York
,
Meenakshi Singh
1   Department of Neonatal-Perinatal Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York
› Author Affiliations
Funding P.C. is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; grant no.: R01HD104909).
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Abstract

Objective Coronavirus disease 2019 (COVID-19) generally causes milder illness in the pediatric population. However, infants represent a higher-risk population with evolving symptomatology and severity. There is a paucity of large population-based data on the impact of COVID-19 on hospitalized infants.

Study Design In this large cohort study, the National Inpatient Sample database was queried for all infant hospital admissions between January and December 2020 in the United States, with and without a diagnosis of COVID-19 based on ICD-10-CM U07. The mortality and morbidity of infants with and without COVID-19 were evaluated. Parent-reported race and outcomes were also analyzed.

Results A weighted total of 3,754,236 infants who were hospitalized were identified, of which 4,265 patients (0.11%) had a concomitant diagnosis of COVID-19. Infants with COVID-19 had similar mortality and extracorporeal membrane oxygenation utilization. Infants with concomitant COVID-19 had a higher rate of respiratory failure, congestive heart failure, acute kidney injury, and coagulopathy. Compared with Caucasian infants and Asian infants, Hispanic and African American infants were more likely to have COVID-19 hospital admissions than hospitalizations without COVID-19 diagnosis. Patients with lower median household income represented the majority of the COVID-19 hospitalization. The infants with COVID-19 were more likely to have Medicaid or Medicare insurance and less likely to have private insurance.

Conclusion In this large cohort of hospitalized infants with COVID-19, the infection was associated with complications, including respiratory failure and endotracheal intubations but not associated with a higher risk for mortality. Infants from racial minorities and lower socioeconomic strata carry the highest burden of COVID-19 infection.

Key Points

  • Infants with COVID-19 represent a higher-risk group with evolving symptomatology and severity.

  • Infants with COVID-19 had similar mortality rates and extracorporeal membrane oxygenation utilization as those without COVID-19.

  • Racial minorities and lower socioeconomic strata carry the highest burden of COVID-19 infection.

Keywords

COVID-19 - infant outcomes - infant hospital admissions

Summary

This large database analysis explores the outcomes of hospitalized infants with COVID-19 as well as the racial and socioeconomic disparities in the disease burden.


What's Known on This Subject

Infants with COVID-19 represent a vulnerable population with added comorbidities owing to prematurity and respiratory illnesses. The sample size and narrow geographic location limit current data regarding the incidence and impact of COVID-19 in infants.


What This Study Adds

Infants with COVID-19 are at risk for complications such as respiratory failure, heart failure, AKI, and coagulopathy. Infants with BPD were at increased risk for COVID-19 hospitalizations. Infants belonging to ethnic minorities carry a higher burden of COVID-19.


Authors' Contributions

P.K. conceptualized and designed the data collection, drafted the initial manuscript, and critically reviewed and revised the manuscript. A.M. and A.I. conceptualized and designed the study, collected the data, performed the initial analysis, and critically reviewed and revised the manuscript. D.B. and A.G. conceptualized and designed the study, coordinated, and supervised the data collection, and critically reviewed and revised the manuscript. L.P., P.C., and M.S. coordinated and supervised the data collection and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.


Supplementary Material



Publication History

Received: 16 March 2023

Accepted: 04 August 2023

Accepted Manuscript online:
07 August 2023

Article published online:
08 September 2023

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