{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:36:55Z","timestamp":1773286615630,"version":"3.50.1"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are limited data on outcomes of SARS-CoV-2 infection among infants (&lt;1 year of age). In the absence of approved vaccines for infants, understanding characteristics associated with hospitalization and severe disease from COVID-19 in this age group will help inform clinical management and public health interventions. The objective of this study was to describe the clinical manifestations, disease severity, and characteristics associated with hospitalization among infants infected with the initial strains of SARS-CoV-2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a national, prospective study of infants with SARS-CoV-2 from April 8\n                      <jats:sup>th<\/jats:sup>\n                      2020 to May 31\n                      <jats:sup>st<\/jats:sup>\n                      2021 using the infrastructure of the Canadian Paediatric Surveillance Program. Infants &lt;1 year of age with microbiologically confirmed SARS-CoV-2 infection from both inpatients and outpatients seen in clinics and emergency departments were included. Cases were classified as either: 1) Non-hospitalized patient with SARS-CoV-2 infection; 2) COVID-19-related hospitalization; or 3) non-COVID-19-related hospitalization (e.g., incidentally detected SARS-CoV-2). Case severity was defined as asymptomatic, outpatient care, mild (inpatient care), moderate or severe disease. Multivariable logistic regression was performed to identify characteristics associated with hospitalization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 531 cases were reported, including 332 (62.5%) non-hospitalized and 199 (37.5%) hospitalized infants. Among hospitalized infants, 141 of 199 infants (70.9%) were admitted because of COVID-19-related illness, and 58 (29.1%) were admitted for reasons other than acute COVID-19. Amongst all cases with SARS-CoV-2 infection, the most common presenting symptoms included fever (66.5%), coryza (47.1%), cough (37.3%) and decreased oral intake (25.0%). In our main analysis, infants with a comorbid condition had higher odds of hospitalization compared to infants with no comorbid conditions (aOR = 4.53, 2.06\u20139.97), and infants &lt;1 month had higher odds of hospitalization then infants aged 1\u20133 months (aOR = 3.78, 1.97\u20137.26). In total, 20 infants (3.8%) met criteria for severe disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We describe one of the largest cohorts of infants with SARS-CoV-2 infection. Overall, severe COVID-19 in this age group was found to be uncommon. Comorbid conditions and younger age were associated with COVID-19-related hospitalization amongst infants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0272648","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T13:32:29Z","timestamp":1661347949000},"page":"e0272648","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical manifestations and disease severity of SARS-CoV-2 infection among infants in Canada"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4632-6877","authenticated-orcid":true,"given":"Pierre-Philippe","family":"Pich\u00e9-Renaud","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc","family":"Panetta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7823-1912","authenticated-orcid":true,"given":"Daniel S.","family":"Farrar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9059-3652","authenticated-orcid":true,"given":"Charlotte","family":"Moore-Hepburn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Drouin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4232-871X","authenticated-orcid":true,"given":"Jesse","family":"Papenburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina I.","family":"Salvadori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Laffin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima","family":"Kakkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9809-0822","authenticated-orcid":true,"given":"Shaun K.","family":"Morris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Canadian Paediatric Surveillance Program COVID-19 Study Team","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"issue":"13","key":"pone.0272648.ref001","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention","volume":"323","author":"Z Wu","year":"2020","journal-title":"JAMA"},{"issue":"10229","key":"pone.0272648.ref002","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"F Zhou","year":"2020","journal-title":"The Lancet"},{"issue":"16","key":"pone.0272648.ref003","doi-asserted-by":"crossref","first-page":"2000508","DOI":"10.2807\/1560-7917.ES.2020.25.16.2000508","article-title":"Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020","volume":"25","author":"A Tostmann","year":"2020","journal-title":"Eurosurveillance"},{"issue":"16","key":"pone.0272648.ref004","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1001\/jama.2020.4326","article-title":"Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State","volume":"323","author":"M Arentz","year":"2020","journal-title":"JAMA"},{"issue":"18","key":"pone.0272648.ref005","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"382","author":"W Guan","year":"2020","journal-title":"New England Journal of Medicine"},{"key":"pone.0272648.ref006","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.mm6937e4","article-title":"SARS-CoV-2\u2013Associated Deaths Among Persons Aged 21 Years\u2014United States, February 12\u2013July 31, 2020","volume":"69","author":"D. 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