791 - Nationwide Analysis of the Epidemiology and Outcomes of Hospitalized infants with COVID-19

Poster Number: 791
Publication Number: 791.249

Parvathy Krishnan, Maria Fareri Children's Hospital at Westchester Medical Center, white plains, NY, United States; aaqib Malik, Wmc, Valhalla, NY, United States; Ameesh Isath, Maria Fareri Children's Hospital at Westchester Medical Center, White Plains, NY, United States; Dhrubajyoti Bandyopadhyay, New York Medical College, New York, NY, United States; Akshay Goel, New York Medical College - Westchester Medical Center, White Plains, NY, United States; Lance Parton, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, United States; Meenakshi Singh, Westchester Medical Center Graduate Medical Education - - vahalla, NY, vahalla, NY, United States

Background: 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.

Objective: The primary outcome was in-hospital mortality. Secondary outcomes included respiratory failure, cardiac arrest, coagulopathy, acute kidney injury (AKI), extracorporeal membrane oxygenation, and endotracheal intubation; with stratification by socio-economic status (SES) and ethnic/racial distribution.

Design/Methods: This is a cohort study of hospitalized infants between January and December 2020 in the United States (US) with COVID-19 using the National Inpatient Sample database. Statistical analyses were performed using Stata 16.0.

Results:
A weighted total of 3,749,971 hospitalized infants were identified with 4,265 patients (0.11%) having a concomitant diagnosis of COVID-19. (Table 1)



 



Infants with COVID-19 had similar mortality and ECMO utilization compared to infants without COVID-19. Infants with COVID-19 had: a higher rate of respiratory failure (5.28 vs 0.82%; p< 0.001); congestive heart failure (0.94 vs 0.19%; p< 0.001); arrhythmias (7.39 vs 0.57%; p< 0.001); cardiac arrest (0.47 vs 0.04%; p< 0.001); AKI (1.17 vs 0.22 %; p< 0.001); liver disease (0.70 vs 0.11%; p=0.0001); and, coagulopathy (2.23 vs 0.17%; p< 0.001). (Table 2)



 



Compared with White infants (26.73% vs 45.81%; p< 0.001) and Asian infants (2.81 vs 4.94%; p), Hispanic (40.91 vs 18.34%; p< 0.001) and Black infants (15.83 vs 13.6%; p< 0.001) were more likely to have COVID-19 than hospitalizations without COVID-19.



 



The infants with a diagnosis of COVID-19 were more likely to have Medicaid or Medicare insurance (73.74% vs 45.92%, p < 0.001) and belong to the lower SES. (Table 2)



 



There was a periodic surge in infant COVID-19 infection with a month-over-month increase in winter months (March- July, and September- December) and a decline in the summer season (July-September). (Figure 1)


Conclusion(s): In this large cohort of hospitalized infants with COVID-19, the infection was not associated with a higher risk for in-hospital mortality. COVID-19 infection was associated with a high risk of associated complications including respiratory failure and endotracheal intubations. Infants belonging to racial and/or ethnic minorities and lower socioeconomic strata carry the highest burden of COVID-19 infection.