Most children with SARS-CoV-2 (the virus that causes COVID-19) infection have mild or no symptoms. However, some children have severe symptoms. We know that risk factors for complications from COVID in children include being younger than 1 year or having an underlying medical condition. Currently, 1 in 4 U.S. children have a long-term condition, including asthma, obesity, and behavioral or learning disorders.

COVID is not always mild in children

Researchers studied what other conditions are most common in children with COVID-19. They also looked at which conditions are linked to severe COVID-19 illness. They studied over 43,465 people 18 years or younger with COVID-19. Of this group, the average age was 12 years, and one third of patients were Hispanic/Latino. They found that one in ten children had to be admitted to the hospital because of COVID. 29% of children with COVID-19 had underlying medical conditions, and 63% needed hospital care. Less than 1% of the children died.

Children with medical and mental health conditions should be considered for vaccination

The most common underlying conditions were asthma, neurodevelopmental disorders (such as autism), anxiety and fear-related disorders, depression, and obesity. Children with heart disease, high blood pressure, and type 1 diabetes had higher risk of hospitalization and severe illness. The fact that type 1 diabetes is a risk factor for severe COVID-19 illness could be explained by complications from pre-existing or new-onset diabetes (which has been seen in association with COVID). More indirectly, type 1 diabetes can be a risk factor for COVID-19 because people often delay seeking care or get a delayed diagnosis. This could result in poor blood sugar control in patients with type 1 diabetes.

Overall, COVID-19 is not always a mild disease in children. Vaccination efforts should prioritize children with these underlying medical conditions.


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