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Cited by 274COVID-19 Clinical Research StudiesCOVID-19 epidemiological studiesSARS-CoV-2 and COVID-19 Research

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Hospitalizations Associated with COVID-19 Among Children and Adolescents — COVID-NET, 14 States, March 1, 2020–August 14, 2021

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Delahoy, Miranda J., Ujamaa, Dawud, Whitaker, Michael, O'Halloran, Alissa, Anglin, Onika, Burns, Erin, Cummings, Charisse, Holstein, Rachel, Kambhampati, Anita K., Milucky, Jennifer, Patel, Kadam, Pham, Huong, Taylor, Christopher A., Chai, Shua J., Reingold, Arthur, Alden, Nisha B., Kawasaki, Breanna, Meek, James, Yousey-Hindes, Kimberly, Anderson, Evan J., Openo, Kyle P., Teno, Kenzie, Weigel, Andy, Kim, Sue, Leegwater, Lauren, Bye, Erica, Como-Sabetti, Kathryn, Ropp, Susan, Rudin, Dominic, Muse, Alison, Spina, Nancy, Bennett, Nancy M., Popham, Kevin, Billing, Laurie M., Shiltz, Eli, Sutton, Melissa, Thomas, Ann, Schaffner, William, Talbot, H. Keipp, Crossland, Melanie T., McCaffrey, Keegan, Hall, Aron J., Fry, Alicia M., McMorrow, Meredith, Reed, Carrie, Garg, Shikha, Havers, Fiona P., COVID-NET Surveillance Team, COVID-NET Surveillance Team, Kirley, Pam Daily, McLafferty, Sarah, Armistead, Isaac, Fawcett, Emily, Ward, Katelyn, Lynfield, Ruth, Danila, Richard, Khanlian, Sarah, Angeles, Kathy, Engesser, Kerianne, Rowe, Adam, Felsen, Christina, Bushey, Sophrena, Abdullah, Nasreen, West, Nicole, Markus, Tiffanie, Hill, Mary, George, Andrea·2021·MMWR. Morbidity and Mortality Weekly Report
DOI 10.15585/mmwr.mm7036e2PMC PMC8437052
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Abstract

Although COVID-19-associated hospitalizations and deaths have occurred more frequently in adults,† COVID-19 can also lead to severe outcomes in children and adolescents (1,2). Schools are opening for in-person learning, and many prekindergarten children are returning to early care and education programs during a time when the number of COVID-19 cases caused by the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, is increasing.§ Therefore, it is important to monitor indicators of severe COVID-19 among children and adolescents. This analysis uses Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET)¶ data to describe COVID-19-associated hospitalizations among U.S. children and adolescents aged 0-17 years. During March 1, 2020-August 14, 2021, the cumulative incidence of COVID-19-associated hospitalizations was 49.7 per 100,000 children and adolescents. The weekly COVID-19-associated hospitalization rate per 100,000 children and adolescents during the week ending August 14, 2021 (1.4) was nearly five times the rate during the week ending June 26, 2021 (0.3); among children aged 0-4 years, the weekly hospitalization rate during the week ending August 14, 2021, was nearly 10 times that during the week ending June 26, 2021.** During June 20-July 31, 2021, the hospitalization rate among unvaccinated adolescents (aged 12-17 years) was 10.1 times higher than that among fully vaccinated adolescents. Among all hospitalized children and adolescents with COVID-19, the proportions with indicators of severe disease (such as intensive care unit [ICU] admission) after the Delta variant became predominant (June 20-July 31, 2021) were similar to those earlier in the pandemic (March 1, 2020-June 19, 2021). Implementation of preventive measures to reduce transmission and severe outcomes in children is critical, including vaccination of eligible persons, universal mask wearing in schools, recommended mask wearing by persons aged ≥2 years in other indoor public spaces and child care centers,†† and quarantining as recommended after exposure to persons with COVID-19.§§.

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FIGURE 1 COVID-19–associated cumulative hospitalizations per 100,000 children and adolescents,* by age group — COVID-NET, 14 states,† March 1, 2020–August 14, 2021 * Rates are subject to change as additional data are reported. † Select counties in California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah.
FIGURE 1 COVID-19–associated cumulative hospitalizations per 100,000 children and adolescents,* by age group — COVID-NET, 14 states,† March 1, 2020–August 14, 2021 * Rates are subject to change as additional data are reported. † Select counties in California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah.CC BY · PubMed Central
FIGURE 2 COVID-19–associated weekly hospitalizations per 100,000 children and adolescents,* by age group — COVID-NET, 14 states,† March 1, 2020–August 14, 2021 (3-week smoothed running averages)§ * Rates are subject to change as additional data are reported. † Select counties in California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah. § Smoothed running averages are used for visualization purposes only.
FIGURE 2 COVID-19–associated weekly hospitalizations per 100,000 children and adolescents,* by age group — COVID-NET, 14 states,† March 1, 2020–August 14, 2021 (3-week smoothed running averages)§ * Rates are subject to change as additional data are reported. † Select counties in California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah. § Smoothed running averages are used for visualization purposes only.CC BY · PubMed Central

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Authors
Delahoy, M. J., Ujamaa, D., Whitaker, M., O'Halloran, A., Anglin, O., Burns, E., Cummings, C., Holstein, R., Kambhampati, A. K., Milucky, J., Patel, K., Pham, H., Taylor, C. A., Chai, S. J., Reingold, A., Alden, N. B., Kawasaki, B., Meek, J., Yousey-Hindes, K., Anderson, E. J., Openo, K. P., Teno, K., Weigel, A., Kim, S., Leegwater, L., Bye, E., Como-Sabetti, K., Ropp, S., Rudin, D., Muse, A., Spina, N., Bennett, N. M., Popham, K., Billing, L. M., Shiltz, E., Sutton, M., Thomas, A., Schaffner, W., Talbot, H. K., Crossland, M. T., McCaffrey, K., Hall, A. J., Fry, A. M., McMorrow, M., Reed, C., Garg, S., Havers, F. P., COVID-NET Surveillance Team, COVID-NET Surveillance Team, Kirley, P. D., McLafferty, S., Armistead, I., Fawcett, E., Ward, K., Lynfield, R., Danila, R., Khanlian, S., Angeles, K., Engesser, K., Rowe, A., Felsen, C., Bushey, S., Abdullah, N., West, N., Markus, T., Hill, M., & George, A.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • General Dynamics (United States) (US)
  • Georgia Department of Public Health (US)
  • Minnesota Department of Health (US)
  • University of California, Berkeley (US)
  • Colorado Department of Public Health and Environment (US)
  • Yale University (US)
  • Michigan Department of Health and Human Services (US)
  • New Mexico Department of Health (US)
  • University of New Mexico (US)
  • New York State Department of Health (US)
  • University of Rochester Medicine (US)
  • Ohio Department of Health (US)
  • Oregon Health Authority (US)
  • Vanderbilt University Medical Center (US)
  • Utah Department of Health (US)
  • Atlanta VA Medical Center (US)
  • Emory University (US)
Corresponding author
Delahoy, Miranda J.
ORCID
Venue
MMWR. Morbidity and Mortality Weekly Report
Publisher
Centers for Disease Control MMWR Office
Published
2021-09-10
Volume
70
Issue
36
Pages
1255-1260
ISSN
  • 0149-2195 (ISSN-L)
  • 1545-861X
DOI
10.15585/mmwr.mm7036e2
PMC
PMC8437052
OpenAlex
W3197266611
Cited by
273
References
8
Citations by year
2026: 3 · 2025: 10 · 2024: 29 · 2023: 56 · 2022: 140 · 2021: 34
FWCI
20.51
Type
journal article
Language
en
Open access
Locations
  • MMWR Morbidity and Mortality Weekly Report (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • U.S. Department of Health and Human Services
  • U.S. Department of Veterans Affairs
  • Pfizer
  • Sanofi
  • New York State Department of Health
  • Minnesota Department of Health
  • Yale University
  • Council of State and Territorial Epidemiologists
  • Vanderbilt University
  • Utah Department of Health
  • Emory University
  • Colorado Department of Public Health and Environment
  • University of Rochester
  • Michigan Department of Health and Human Services
  • Ohio Department of Health
  • Vanderbilt University Medical Center
  • Moderna
  • National Institutes of Health (COVID-19)
  • Centers for Disease Control and Prevention
  • School of Medicine, Emory University
  • Medical Center, University of Rochester
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Keywords
COVID-19 pandemic, hospitalization, children, adolescents, pediatric COVID-19, COVID-NET, SARS-CoV-2
MeSH terms
COVID-19, SARS-CoV-2, COVID-19 Vaccines, Adolescent, Child, Child, Preschool, Hospitalization, Humans, Infant, Infant, Newborn, Severity of Illness Index, United States, Vaccination

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