{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:47:57Z","timestamp":1768549677346,"version":"3.49.0"},"posted":{"date-parts":[[2020,10,30]]},"group-title":"Epidemiology","reference-count":30,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2020,10,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children\/adolescents diagnosed or hospitalized with COVID-19. Secondly, to describe health outcomes amongst children\/adolescents diagnosed with previous seasonal influenza.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>International network cohort.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Real-world data from European primary care records (France\/Germany\/Spain), South Korean claims and US claims and hospital databases.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Diagnosed and\/or hospitalized children\/adolescents with COVID-19 at age &lt;18 between January and June 2020; diagnosed with influenza in 2017-2018.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Baseline demographics and comorbidities, symptoms, 30-day in-hospital treatments and outcomes including hospitalization, pneumonia, acute respiratory distress syndrome (ARDS), multi-system inflammatory syndrome (MIS-C), and death.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 55,270 children\/adolescents diagnosed and 3,693 hospitalized with COVID-19 and 1,952,693 diagnosed with influenza were studied.<\/jats:p>\n                  <jats:p>Comorbidities including neurodevelopmental disorders, heart disease, and cancer were all more common among those hospitalized vs diagnosed with COVID-19. The most common COVID-19 symptom was fever. Dyspnea, bronchiolitis, anosmia and gastrointestinal symptoms were more common in COVID-19 than influenza.<\/jats:p>\n                  <jats:p>In-hospital treatments for COVID-19 included repurposed medications (&lt;10%), and adjunctive therapies: systemic corticosteroids (6.8% to 37.6%), famotidine (9.0% to 28.1%), and antithrombotics such as aspirin (2.0% to 21.4%), heparin (2.2% to 18.1%), and enoxaparin (2.8% to 14.8%).<\/jats:p>\n                  <jats:p>Hospitalization was observed in 0.3% to 1.3% of the COVID-19 diagnosed cohort, with undetectable (N&lt;5 per database) 30-day fatality. Thirty-day outcomes including pneumonia, ARDS, and MIS-C were more frequent in COVID-19 than influenza.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite negligible fatality, complications including pneumonia, ARDS and MIS-C were more frequent in children\/adolescents with COVID-19 than with influenza. Dyspnea, anosmia and gastrointestinal symptoms could help differential diagnosis. A wide range of medications were used for the inpatient management of pediatric COVID-19.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>What is already known on this topic?<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>Most of the early COVID-19 studies were targeted at adult patients, and data concerning children and adolescents are limited.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Clinical manifestations of COVID-19 are generally milder in the pediatric population compared with adults.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Hospitalization for COVID-19 affects mostly infants, toddlers, and children with pre-existing comorbidities.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>What this study adds<\/jats:title>\n                  <jats:list list-type=\"simple\">\n                    <jats:list-item>\n                      <jats:label>\u2370<\/jats:label>\n                      <jats:p>This study comprehensively characterizes a large international cohort of pediatric COVID-19 patients, and almost 2 million with previous seasonal influenza across 5 countries.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:label>\u2370<\/jats:label>\n                      <jats:p>Although uncommon, pneumonia, acute respiratory distress syndrome (ARDS) and multi-system inflammatory syndrome (MIS-C) were more frequent in children and adolescents diagnosed with COVID-19 than in those with seasonal influenza.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:label>\u2370<\/jats:label>\n                      <jats:p>Dyspnea, bronchiolitis, anosmia and gastrointestinal symptoms were more frequent in COVID-19, and could help to differentiate pediatric COVID-19 from influenza.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:label>\u2370<\/jats:label>\n                      <jats:p>A plethora of medications were used during the management of COVID-19 in children and adolescents, with great heterogeneity in the use of antiviral therapies as well as of adjunctive therapies.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>","DOI":"10.1101\/2020.10.29.20222083","type":"posted-content","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T13:45:19Z","timestamp":1604065519000},"source":"Crossref","is-referenced-by-count":21,"title":["Baseline characteristics, management, and outcomes of 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