Our understanding of COVID-19 illness in children is limited. To date, most children with SARS-CoV-2 infection have been asymptomatic or had mild COVID-19 symptoms, but some children have had severe illness. Prior literature identified risk factors for severe COVID-19 illness in children, including being younger than 1 year or having an underlying medical condition, such as congenital heart disease, asthma, obesity, diabetes, or neurologic conditions. Approximately 1 in 4 US children have a chronic condition, including asthma, obesity, and behavioral or learning disorders.

A study published in JAMA Network Open was conducted to determine among children with a COVID-19 diagnosis, what conditions were common, and which were associated with severe COVID-19 illness. The study included 43,465 patients aged 18 years or younger with COVID-19, more than one-quarter had 1 or more underlying conditions; asthma, obesity, neurodevelopmental disorders, and certain mental health conditions were most common.

The study found a higher risk of severe COVID-19 illness among children with medical complexity and certain underlying conditions, such as type 1 diabetes, cardiac and circulatory congenital anomalies, and obesity. Health care practitioners are encouraged to consider the potential need for close observation and cautious clinical management of children with these conditions and COVID-19. Stay well, stay informed, and stay tuned!