Comparison of Influenza and Coronavirus Disease 2019–Associated Hospitalizations Among Children Younger Than 18 Years Old in the United States: FluSurv-NET (October–April 2017–2021) and COVID-NET (October 2020–September 2021)

Author:

Delahoy Miranda J123ORCID,Ujamaa Dawud12,Taylor Christopher A1,Cummings Charisse12,Anglin Onika1,Holstein Rachel12,Milucky Jennifer1,O’Halloran Alissa12,Patel Kadam1,Pham Huong1,Whitaker Michael1,Reingold Arthur45,Chai Shua J46,Alden Nisha B7,Kawasaki Breanna7,Meek James8,Yousey-Hindes Kimberly8,Anderson Evan J91011ORCID,Openo Kyle P91011,Weigel Andy12,Teno Kenzie12,Reeg Libby13,Leegwater Lauren13,Lynfield Ruth14,McMahon Melissa14,Ropp Susan15,Rudin Dominic15,Muse Alison16,Spina Nancy16,Bennett Nancy M17,Popham Kevin18,Billing Laurie M19,Shiltz Eli19,Sutton Melissa20,Thomas Ann20,Schaffner William21,Talbot H Keipp21,Crossland Melanie T22,McCaffrey Keegan23,Hall Aron J1,Burns Erin2,McMorrow Meredith1,Reed Carrie2ORCID,Havers Fiona P1,Garg Shikha12

Affiliation:

1. CDC COVID-19 Response Team, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

2. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

3. Epidemic Intelligence Service, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

4. California Emerging Infections Program , Oakland, California , USA

5. Berkeley School of Public Health, University of California , Berkeley, California , USA

6. Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

7. Colorado Department of Public Health and Environment , Denver, Colorado , USA

8. Connecticut Emerging Infections Program, Yale School of Public Health , New Haven, Connecticut , USA

9. Emory University School of Medicine , Atlanta, Georgia , USA

10. Georgia Department of Health, Georgia Emerging Infections Program , Atlanta, Georgia , USA

11. Atlanta Veterans Affairs Medical Center , Atlanta, Georgia , USA

12. Iowa Department of Health , Des Moines, Iowa , USA

13. Michigan Department of Health and Human Services , Lansing, Michigan , USA

14. Minnesota Department of Health , Saint Paul, Minnesota , USA

15. New Mexico Department of Health, New Mexico Emerging Infections Program , Santa Fe, New Mexico , USA

16. New York State Department of Health , Albany, New York , USA

17. University of Rochester School of Medicine and Dentistry , Rochester, New York , USA

18. Rochester Emerging Infections Program, University of Rochester Medical Center , Rochester, New York , USA

19. Ohio Department of Health , Columbus, Ohio , USA

20. Public Health Division, Oregon Health Authority , Salem, Oregon , USA

21. Vanderbilt University Medical Center , Nashville, Tennessee , USA

22. Salt Lake County Health Department , Salt Lake City, Utah , USA

23. Utah Department of Health , Salt Lake City, Utah , USA

Abstract

Abstract Background Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. Methods Influenza- and COVID-19–associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, 2 population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19–associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (1 October 2020–30 September 2021) was compared with influenza-associated hospitalization rates during the 2017–2018 through 2019–2020 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. Results Among children <18 years, the COVID-19–associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017–2018 (33.5), 2018–2019 (33.8), and 2019–2020 (41.7). The COVID-19–associated hospitalization rate was higher among adolescents 12–17 years old (COVID-19: 59.9; influenza range: 12.2–14.1), but similar or lower among children 5–11 (COVID-19: 25.0; influenza range: 24.3–31.7) and 0–4 (COVID-19: 66.8; influenza range: 70.9–91.5) years old. Among children <18 years, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; P < .01). Pediatric deaths were uncommon during both COVID-19– and influenza-associated hospitalizations (0.7% vs 0.5%; P = .28). Conclusions In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19–associated hospitalization rate during 2020–2021 was higher among adolescents and similar or lower among children <12 years compared with influenza during the 3 seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses.

Funder

Centers of Disease Control and Prevention

Council of State and Territorial Epidemiologists

Michigan Department of Health and Human Services

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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