This is a summary, written by members of the CITF Secretariat, of:

Funk AL, Florin TA, Kuppermann N, Tancredi DJ, Xie J, Kim K, Neuman MI, Ambroggio L, Plint AC, Mintegi S, Klassen TP. Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments: The Global PERN–COVID-19 Study. JAMA Network Open. 2022 Jan 4;5(1):e2142322-.

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

A recent publication in JAMA Network Open from The Pediatric Emergency Research Network (PERN)-COVID-19, headed by CITF-funder researcher Dr. Stephen B. Freedman from the University of Calgary, looked at the profile and disease experience of youths under the age of 18 who sought treatment for SARS-CoV-2 in emergency departments in ten countries. Whereas the risk of severe outcomes among youths within this age group is low – only 3% of SARS-CoV-2 positive youths sought care in an emergency department – those who did have severe disease. As with adults, many of the youths who sought emergency care had pre-existing conditions and severe manifestations.

This study examined the records of 10,382 youth in 10 countries who went to emergency departments and were given a SARS-CoV-2 PCR between March 7, 2020, and June 15, 2021. This study focussed on youths who tested positive for COVID-19. Children and teenagers who tested negative were used as a comparator group. Participants from two study sites in Australia and New Zealand were all SARS-CoV-2 negative and were therefore included in the comparison group. Included in the definition of severe outcomes in the study were cardiovascular or neurological complications, infections including septic shock and toxic shock syndrome, respiratory syndromes, and death.

Key Findings

  • 31% (n=3222) of study participants tested positive for SARS-CoV-2 and 3048 participants among these were symptomatic.
  • Among them:
    • 6% were males of a median age of 3 (range- 0-10 years old);
    • 15% self-reported pre-existing chronic underlying conditions;
    • 2325 (76.3%) presented with respiratory symptoms.
    • 2125 (69.7%) presented with fever.
    • 172 (5.3%) were asymptomatic.
  • 685 (21.3%) of the COVID-19 positive individuals were hospitalized. Among them, 91 patients were admitted to the intensive care unit (ICU) from the ED.
  • 630 (92%) were discharged in less than 14 days while 55 (8%) were discharged after 14 days.
  • 95 of the 685 hospitalized youths suffered severe outcomes (as defined above), while four ultimately died.
  • Severe outcomes were most common among youths between the ages of 10 and 17, and least common among those under 1 year of age.
  • 541 (87.5%) of those who were hospitalized did not return to the clinic/hospital following discharge, while 77 youths did seek further care, of whom 27 were subsequently hospitalized due to prolonged severe symptoms.
  • Of those who were discharged from the ED without admission (2536 (78.7%)), 2190 (87.3%) did not seek further treatment.
  • 320 (12.7%) from this group came back to the clinic/hospital due to worsening or persistent symptoms. 50 (2%) were eventually hospitalized and 12 (0.5%) had severe outcomes but none died.
  • Severe outcomes were common among those with self-reported chronic underlying. Among these 320-youth specific reasons were known for 151 (47.2%), the most common among those were fever and cough in 31.1% and 27.8% of youths respectively. conditions.

The study incorporated 41 emergency departments (ED) across 10 countries including Canada, the United States, Argentina, Australia, Costa Rica, Italy, New Zealand, Paraguay, Singapore, and Spain between March 2020 and June 2021. Most of the participants – more than 62% – were in the United States. Overall, the study shows that while severe outcomes in youth are less common than among adults, they are often linked with underlying chronic conditions/illness.