The reported number of COVID-19 hospitalizations, one of the primary metrics for tracking the severity of the coronavirus pandemic, was grossly inflated for children in California hospitals, two research papers published Wednesday concluded. The papers, both published in the journal Hospital Pediatrics, found that pediatric hospitalizations for COVID-19 were overcounted by at least 40 percent, carrying potential implications for nationwide figures.
Dr. Monica Gandhi, an infectious-diseases specialist at the University of California, San Francisco, and Amy Beck, an associate professor of pediatrics, also at UCSF, wrote a commentary for Hospital Pediatrics that accompanied the two studies. They wrote, “Taken together, these studies underscore the importance of clearly distinguishing between children hospitalized with SARS-CoV-2 found on universal testing versus those hospitalized for COVID-19 disease.” The studies demonstrate, they said, that reported hospitalization rates “greatly overestimate the true burden of COVID-19 disease in children.” Gandhi told Intelligencer that while the studies were both conducted with data from California hospitals, “there is no reason to think these findings would be exclusive to California. This sort of retrospective chart review will likely reveal the same findings across the country.”
The implications of the findings of these two studies are enormously important, as reports of pediatric hospitalizations have regularly made headlines over the past year, greatly affecting public perceptions about risks to children. Untold numbers of parents have kept children home from school or limited playdates and other activities out of fear their children would be infected and fall seriously ill. The hospitalization numbers for children were already extremely low relative to adults — at the pandemic’s peak this winter, it was roughly ten times lower than for 18-to-49-year-olds and 77 times lower than those age 65 and up. But cutting the pediatric numbers by nearly half is a striking difference, making the actual rates vanishingly small. Pediatric hospitalization figures for COVID-19 also influence policy on school openings and guidelines, camp recommendations, and other political decisions. Gandhi and Beck’s commentary noted, “Children have suffered tremendously due to policies that have kept schools and recreational facilities closed to them, and the burden has been greatest on children who are low-income and English-language learners.”
In one study, conducted at a children’s hospital in Northern California, among the 117 pediatric SARS-CoV2-positive patients hospitalized between May 10, 2020, and February 10, 2021, the authors concluded that 53 of them (or 45 percent) “were unlikely to be caused by SARS-CoV-2.” The reasons for hospital admission for these “unlikely” patients included surgeries, cancer treatment, a psychiatric episode, urologic issues, and various infections such as cellulitis, among other diagnoses. The study also found that 46 (or 39.3 percent) of patients coded as SARS-CoV2 positive were asymptomatic. In other words, despite patients’ testing positive for the virus as part of the hospital’s universal screening, COVID-19 symptoms were absent, therefore it was not the reason for the hospitalization. Any instance where the link between a positive SARS-CoV2 test and cause of admission was uncertain the authors erred toward giving a “likely” categorization. (Read more from “New Research Shows Number of Kids Hospitalized for COVID Is Majorly Overcounted” HERE)
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