CDC: COVID-19 Hospitalizations of Adolescents Reinforce Need for Prevention

Adolescents are less likely than adults to be hospitalized with COVID-19, but the risk of hospitalization is about three times greater than for influenza, according to data recently released by the US Centers for Disease Control and Prevention.

The study, published in a recent Morbidity and Mortality Weekly Report, examined hospitalization in adolescents ages 12-17 with COVID-19 between March 1, 2020, and April 24, 2021. It included 204 hospitalized adolescents, with nearly a third (64) requiring ICU admission and 5% (10) requiring mechanical ventilation. None of the adolescents in the study died.

“I am deeply concerned by the numbers of hospitalized adolescents and saddened to see the number of adolescents who required treatment in intensive care units or mechanical ventilation,” CDC Director Rochelle Walensky, MD, MPH, said in a statement. “Much of this suffering can be prevented.”

She urged adolescents to continue to wear masks and take precautions until they are fully vaccinated.

“Vaccination is our way out of this pandemic,” Walensky said.

The study analyzed data from COVID-NET, a population-based surveillance system of laboratory-confirmed COVID-19–associated hospitalizations in 99 counties across 14 states.

Hospitalization rates fluctuated during that time, peaking at 2.1 per 100,000 in early January 2021 and falling to 0.6 in mid-March before edging back up to 1.3 in April. Overall, hospitalization rates associated with COVID-19 were 2.5 to 3 times higher than those associated with influenza, despite ongoing prevention measures, such as school closures, mask wearing and physical distancing that were followed during the pandemic.

The cumulative COVID-19–associated adolescent hospitalization rate was 12.5 times lower than that in adults, the study showed. Weekly hospitalization rates were higher than those of children ages 5-11 but similar to 0- to 4-year-olds.

“Recent increased hospitalization rates and the potential for severe disease reinforce the importance of continued COVID-19 prevention measures among adolescents, including vaccination and correct and consistent wearing of masks,” the report noted.

Most hospitalized adolescents (70.6%) had an underlying medical condition such as obesity (35.8%), asthma (30.9%) or diabetes (11.8%), which was less than the 92% of hospitalized adults who had underlying conditions. Nearly two-thirds of hospitalized adolescents were Hispanic of non-Hispanic Black, consistent with previous research showing a disproportionate burden of COVID-19 among minority communities.

Some limitations pointed out by the report include that the primary reason for hospitalization wasn’t always clear. Overall, 376 adolescents were hospitalized during the time of the study, with about 45.7% (172) having positive SARS-CoV-2 tests, which may not have been their primary reason for hospitalization. These cases were analyzed separately but included in hospitalization rate calculations. Also, the study included laboratory-confirmed cases, which could be affected by variation in testing policies. The study also may not have included some adolescents with severe disease, if they were admitted more than 14 days after testing positive.

“Expansion of COVID-19 vaccination of adolescents, with particular attention to racial and ethnic minority groups disproportionately affected by severe COVID-19, is expected to reduce COVID-19–associated morbidity within this age group,” the study noted.

The findings are consistent with other recent research.

Data from electronic hospital records collected by Consortium for Clinical Characterization of COVID-19 by EHR have helped increase understanding of how the disease affects children, who are much less likely to develop severe disease or require hospitalization than adults.

A recent study found that multisystem inflammatory syndrome (MIS-C), a rare but serious complication of COVID-19, occurs in about 316 per million people younger than 21 years, with incidences more common among Black, Hispanic and Asian youth.

Another recent study in London found that corticosteroids could potentially be an effective treatment for children who develop MIS-C. The study noted that corticosteroids are less expensive than immunoglobulin and available worldwide.