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Is race associated with COVID-19 testing and hospital outcomes in children, finds NEJM study
Although children mainly experience mild COVID-19 disease, hospitalization rates are increasing, with limited understanding of underlying factors. Studies have shown an established association between race and severe COVID-19 outcomes in adults, however whether a similar association in children exists is unclear. In the latest JAMA pediatrics, Saatci et al from University of Oxford explored the association between race, SARS-CoV2 infection and hospitalization rates and showed that Asian children were significantly more likely to have COVID-19 hospital and ICU admissions compared with White children.
In this large population based cohort study used 2576353 children (0-18 years of age) to investigate the association between race and pediatric COVID-19 outcomes in the United Kingdom. A total of 1 311 041 (50.9%) were identified as white children and 484 694 of the 2 576 353 patients (18.8 %) were. identified as Asian, Black, and mixed or other racial categories.During the study, 410726 children (15.9%) underwent SARS-CoV-2 testing, with positive results in 26322 (6.4%). A total of 343 (53.6%) required hospital admission and 73 children were admitted in ICU.
Important findings of the study are-
-White children had the highest percentage of SARS-CoV-2 tests whereas children of all other races had lower percentages (Asian; mixed or/ and Black).
-In children who were tested, those from Asian ,Black and mixed or other backgrounds had higher odds of positive test results compared to White children .
-Older children (16-18 years of age) were also more likely to have a positive test result for SARS-CoV-2 compared with infants (0-3 months of age) with p<0.001.
-Asian children were also more likely to be admitted to the hospital for confirmed COVID-19 compared with White children.
-Black children and children of mixed or other races had significantly more hospitalizations that were 36 hours or longer compared with White children.
-Race was also associated with ICU admissions. Asian children had a significantly higher odds ratio for COVID-19 ICU admissions compared with White children.
After accounting for important socio-demographic and clinical factors that are associated with COVID-19 disease, this population-based cohort study provides, to our knowledge, the most evidence to date of race-specific disparities across SARSCoV-2 testing and COVID-19 hospitalizations in children. Results of this study indicate that race-specific disparities in SARS-CoV-2 testing and COVID-19 hospital outcomes seen in adults also exist among children.
Authors conclude-"This study reinforces the continued need for race/ethnicity-tailored focus on health system performance and targeted public health interventions in children, not only during the ongoing COVID-19 pandemic but also in the event of future public health threats."
Source: Saatci D, Ranger TA, Garriga C, Clift AK, Zaccardi F, Tan PS, Patone M, Coupland C, Harnden A, Griffin SJ, Khunti K, Dambha-Miller H, Hippisley-Cox J. Association Between Race and COVID-19 Outcomes Among 2.6 Million Children in England. JAMA Pediatr. 2021 Jun 21. doi: 10.1001/jamapediatrics.2021.1685.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751