Heda Dapul, MD, FAAP
NYU Langone Medical Center and School of Medicine
Brooklyn
Disclosure information not submitted.
Sandeep Tripathi, MD, MS
Associate Professor of Pediatrics
University of Illinois College of Medicine at Peoria
Peoria, Illinois
Disclosure information not submitted.
Joshua Kuehne
Medical Student
University of The Incarnate Word School of Osteopathic Medicine, United States
Disclosure information not submitted.
Michelle Ramirez, MD
Hassenfeld Children's Hospital at NYU Langone
Brooklyn, NY
Disclosure information not submitted.
Logi Rajagopalan, MD
Physician
Hassenfeld Children's Hospital at NYU Langone, United States
Disclosure information not submitted.
Tyler Tolopka
Medical Student
University of The Incarnate Word School of Osteopathic Medicine, United States
Disclosure information not submitted.
Mohammed Salameh, MD
Assistant Professor
Childrens Hospital of San Antonio
San Antonio, Texas
Disclosure information not submitted.
Karen Boman
Business Analyst
Society of Critical Care Medicine, United States
Disclosure information not submitted.
Vishakha Kumar, MD, MBA
Society of Critical Care Medicine
Mount Prospect, Illinois
Disclosure information not submitted.
Benard Dreyer, MD, FAAP
Professor of Pediatrics
NYU School of Medicine and Bellevue Hospital Center, United States
Disclosure information not submitted.
Utpal Bhalala, MD, , FCCM
Pediatric Intensivist, Associate Professor, Research Advisor
Driscoll Children's Hospital
Corpus Christi
Disclosure information not submitted.
Title: Racial-Ethnic Disparities in Outcomes of Children Hospitalized for COVID-19: A VIRUS Registry Report
Introduction: Adult racial and ethnic minorities in the U.S. with COVID-19 are known to have worse outcomes. The CDC reported higher incidence of COVID-19 among minority children, but data regarding disparities in pediatric COVID-19 outcomes remains limited.
Methods: A total of 837 children < 18 years of age hospitalized with COVID-19 in the U.S. were entered into the SCCM VIRUS Registry from 03/2020 to 01/2021. They were grouped into either of the following: Hispanic, non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, Other or Unknown. Demographic and clinical characteristics, interventions and outcomes were compared. Critical illness was defined using a composite index of in-hospital mortality and organ support requirement, including vasopressors/inotropes, ECMO and CRRT. Comparisons were made using ANOVA, Kruskal-Wallis or Pearson’s Chi-square. We used multivariable logistic and linear regression analysis to examine associations between race and ethnicity and critical illness, hospital and ICU length of stay and hospital mortality.
Results: Fever was reported in 67%, with no difference among the groups. MIS-C was reported with a significantly higher proportion in non-Hispanic Blacks (36%) than in non-Hispanic Whites (26%) [p=0.02]. Adjusting for age, sex, obesity, immune compromise and asthma, the non-Hispanic Asian group was significantly associated with higher odds of critical illness [OR=5.83, 95% CI=2.13-15.81]. Non-Hispanic Blacks also had higher odds of critical illness than non-Hispanic Whites, though not significant [OR=1.59, 95% CI=0.99-2.54]. With each yearly increase in age, the odds of critical illness was higher [OR=1.04, 95% CI=0.99-1.07] given all other covariates remain the same. While there was a higher proportion of obesity in the Hispanic group, this did not increase their odds of critical illness. Non-Hispanic Blacks had longer hospital length of stay compared to non-Hispanic Whites, though not significant [OR=1.76, 95% CI=-0.17-3.68]. ICU length of stay and mortality were not significantly associated with race or ethnicity.
Conclusion: Racial and ethnic disparities in pediatric COVID-19 outcomes exist that are not associated with pre-existing conditions. These findings may guide the allocation of critical care resources towards minority groups at higher risk for severe disease.