Hospitalization for COVID-19 and Risk Factors for Severe Disease Among Children: 2022-2024.

Publication date: Jul 03, 2025

We assessed characteristics associated with pediatric COVID-19 hospitalizations and risk factors for severe disease among hospitalized children ≥6 months. Using data from COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) during October 1, 2022-April 30, 2024, we described demographic characteristics, underlying medical conditions, COVID-19 vaccination status, and clinical outcomes, including severe disease (ICU admission, mechanical ventilation, extracorporeal membrane oxygenation, in-hospital death), of hospitalized children 6 months-17 years residing in the COVID-NET catchment area with laboratory-confirmed SARS-CoV-2 infection. Multivariable log-linked Poisson generalized estimating equations were conducted to assess risk factors for severe disease among children 6-23 months and 2-17 years. Of 2,490 children hospitalized for COVID-19, 1114 (44. 7%) were 6-23 months; 1358 (54. 1%) were male. Overall, 1464 (58. 9%) had ≥1 underlying conditions: 471 (41. 8%) of children 6-23 months, 290 (61. 6%) 2-4 years, 383 (79. 2%) 5-11 years, and 320 (77. 0%) 12-17 years. 100 (3. 8%) were up-to-date with recommended COVID-19 vaccination. Among children 6-23 months, severe disease was associated with underlying chronic lung (adjusted risk ratio [aRR] 1. 5, 95% CI: 1. 2-1. 8) and cardiovascular disease (aRR: 1. 4, 95% CI: 1. 1-1. 7). Among children ≥2 years, severity was associated with chronic lung disease (aRR: 1. 9, 95% CI: 1. 5-2. 3), diabetes (aRR: 1. 5, 95% CI: 1. 2-1. 8), and neurologic disorders (aRR: 1. 4, 95% CI: 1. 2-1. 6). Most hospitalized children ≥6 months had ≥1 underlying conditions and

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