Study shows similar hospitalization, ICU admission rates among kids with COVID-19, flu
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In a single-center study, researchers observed no significant differences in mechanical ventilator use, hospitalization or ICU admission rates among children with COVID-19 compared with children with influenza.
“There may have been either an under- or overestimation of the potential severity of COVID in children. This paper now places that estimate in context of something clinicians are familiar with: influenza,” Xiaoyan Song, MBBS, PhD, MSc, director of infection control and epidemiology at Children’s National Hospital in Washington, D.C., and professor of pediatrics at George Washington University, told Healio.
“The study showed both COVID-19 and flu can cause serious disease and cause similar harm to children,” Song said. “Although our study showed that patients with COVID-19 were more likely than patients with flu to report fever, gastrointestinal and other clinical symptoms at the time of diagnosis, the two groups do have many overlapping clinical symptoms.”
Song and colleagues included 315 children with COVID-19 and 1,402 children with seasonal influenza who were admitted to Children’s National between March 25 and May 15. They assessed hospitalization and ICU admission rates, mechanical ventilator use and the connection between clinical symptoms related to COVID-19 versus influenza.
Children with COVID-19 and children with influenza experienced similar hospitalization rates (17% vs. 21%; P = .15), ICU admission rates (6% vs. 7%; P = .42) and mechanical ventilator use (3% vs. 2%; P = .17). Patients hospitalized with COVID-19 reported fever more frequently than children with influenza (76% vs. 55%; P = .005), as well as diarrhea or vomiting (26% vs. 12%; P = .01), headache (11% vs. 3%; P = .01), myalgia or body ache (22% vs. 7%; P = .001) and chest pain (11% vs. 3%; P = .01). They did not observe significant differences related to shortness of breath and cough between the two patient groups.
“Both COVID-19 and flu are detectable, and many laboratory diagnostic kits are available on the market,” Song said. “When these diagnostic tests are used properly, it will help to distinguish the infections caused by these two different viruses. The test results will guide treatment option and help to resolve issues related to similar clinical features.”
Song noted that the study’s major limitation was that it was a single-center analysis, and a future multicenter study with a larger sample size and a heterogenous population could improve the results’ generalizability. She said it was surprising to observe similarities in patient outcomes like ICU admission rates, hospitalization rates and mechanical ventilation use.
“It is a surprise, and a sad reminder that both viruses can be equally dangerous to children,” Song said. “Though COVID-19 has raised great concerns, it is prudent to remind parents to get their kids vaccinated with the flu vaccine as soon as feasible.”
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