299 - Pediatric Patient Outcomes and Complications after SARS-CoV-2 Infection

Poster Number: 299
Publication Number: 299.215

Maryam Khodaverdi, West Virginia University CTSI, Morgantown, WV, United States; Bradley Price, West Virginia University, Morgantown, WV, United States; Kamakshya Patra, WVU Medicine, Morgantown, WV, United States; Lee Pyles, Lee Pyles, Morgantown, WV, United States

Background: Many studies have investigated the effect of pre-existing conditions on complications after SARS-CoV2 infection for adults. The relationship can help community to identify high risk groups.

Objective: This study analyzes the relationship between pre-existing conditions and complications after COVID-19 infection in pediatric patients.

Design/Methods: A cohort of 447,745 patients is studied from the National COVID Cohort Collaboration (N3C) registry between March 2020-December 2021. All patients that were diagnosed with COVID-19 and less than 18 years old are included. N3C data has been provided by 68 partners and 1125 care sites all over United States.
We consider asthma, hypertension, cancer, liver problems, and congestive heart failure prior to a patient’s first COVID-19 diagnosis as the pre-existing conditions of interest. Outcome or complications after the first COVID-19 diagnosis includes pulmonary disease and pneumonia, acute renal failure, acute respiratory distress syndrome (ARDS), multisystem inflammatory syndrome (MISC), and death. Demographic information such as age, gender, race, and ethnicity are also considered. Note that BMI is not available for most of pediatric patients in this cohort. Table 1 summarizes the frequency of post COVID-19 complications, the adjusted odds ratio (aOR), and 95% confidence intervals after adjusting for demographics as a measure to demonstrating the risk associated with patient group.

Results: The most common pre-existing condition in the cohort was asthma (6.39%) and the most common complication was related to pulmonary disease (1.96%). Patients with cancer prior to their first COVID-19 diagnosis had the highest odds of mortality (aOR: 25.82 (16.93, 38.64); p< 0.001) and, patients with congestive heart failure had a highest odd of MISC (aOR: 5.31 (2.28, 10.83); p< 0.001) within patient’s group with different conditions. Patients with hypertension had highest chance of ARDS (aOR: 8.05 (5.84, 10.87); p< 0.001) and renal failure (aOR: 107.42 (89.43,129), p< 0.001) compared to other pre-existing conditions. The likelihood of pulmonary complications after COVID-19 infection is very high in patients with asthma (aOR: 31.98 (30.77, 33.25); p< 0.001). Table 1 contains information on other results of interest.Conclusion(s): The presence of studied pre-existing conditions is associated with complications after COVID-19 infection among children. Patient with cancer have high risk of death, and patient with hypertension have high risk of developing renal complication. Also, patient with asthma are more likely to have pulmonary complications after COVID-19 infection.
Table 1: Summary table and odd ratios of COVID-19 complications related to pre-existing conditions among pediatric patients1- Reference group (aOR=1) are male, White, not Hispanic or Latino, without any of pre-existing conditions.
2- Significant p-values marked with asterisk.
3- Congestive Heart Failure