SynthesisJournal of the Pediatric Infectious Diseases Society2024
Risk Factors for Pediatric Critical COVID-19: A Systematic Review and Meta-Analysis.
Synthesis in Journal of the Pediatric Infectious Diseases Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Risk Factors of COVID-19 Severity and Related Death in Children in the Post-Pandemic Era.Microorganisms · 2026Article
- Disease severity among hospitalized children during the COVID-19 pandemic in Israel.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Article
- Survival analysis and mortality predictors of COVID-19 in Moroccan children: A multicenter study.IJID regions · 2026Article
- Acute Respiratory Tract Infections and Severe Disease Among Hospitalized Children.JAMA network open · 2026Article
- Characteristics of Young Children Hospitalized With Acute Respiratory Failure From Infection With Respiratory Syncytial Virus, SARS-CoV-2, or Both, November 2023-March 2024.Open forum infectious diseases · 2026Article
- COVID-19 burden in the paediatric population in Latin America during vaccine rollout: a real-world study using national surveillance data.BMC infectious diseases · 2026Observational
- Impaired Generation of High-Affinity Memory B Cells and Neutralizing Antibodies Against SARS-CoV-2 in Adolescents and Young Adults With Juvenile Idiopathic Arthritis Treated With Tumor Necrosis Factor Inhibitors.ACR open rheumatology · 2026Article
- Article
- Humoral immunity and clinical characteristics of Chinese college students experiencing a BA.5/BF.7 and XBB.1.5 wave.Scientific reports · 2025Article
- Heterogeneity in Racial and Ethnic Disparities in COVID-19 Severity Among Pediatric Inpatients in a National Healthcare Database.Journal of the Pediatric Infectious Diseases Society · 2025Observational
- COVID-19-Related Healthcare Resource Utilisation and Costs in Paediatric Patients in Germany: A Population-Based Study.Advances in therapy · 2025Article
- Duration of COVID-19 symptoms in children: a longitudinal study in a Rio de Janeiro favela, Brazil.BMJ open · 2025Article
- Pediatric COVID-19 Hospitalization Trends by Race and Ethnicity, 2020-2023.JAMA network open · 2025Observational
- Review
- Article
- Clinical characteristics and burden of COVID-19 in children and adolescents in Colombia: a retrospective database analysis.BMJ paediatrics open · 2025Article
- Management of SARS-CoV-2 Infection-Clinical Practice Guidelines of the Polish Association of Epidemiologists and Infectiologists, for 2025.Journal of clinical medicine · 2025Review
- COVID-19 pandemic and enrollment of critically Ill children in randomized clinical trials.Frontiers in pediatrics · 2025Article
- Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundRisk stratification is a cornerstone of the Pediatric Infectious Diseases Society COVID-19 treatment guidance. This systematic review and meta-analysis aimed to define the clinical characteristics and comorbidities associated with critical COVID-19 in children and adolescents.
methodsTwo independent reviewers screened the literature (Medline and EMBASE) for studies published through August 31, 2023, that reported outcome data on patients aged ≤21 years with COVID-19. Critical disease was defined as an invasive mechanical ventilation requirement, intensive care unit admission, or death. Random-effects models were used to estimate pooled odds ratios (OR) with 95% confidence intervals (CI), and heterogeneity was explored through subgroup analyses.
resultsAmong 10,178 articles, 136 studies met the inclusion criteria for review. Data from 70 studies, which collectively examined 172,165 children and adolescents with COVID-19, were pooled for meta-analysis. In previously healthy children, the absolute risk of critical disease from COVID-19 was 4% (95% CI, 1%-10%). Compared with no comorbidities, the pooled OR for critical disease was 3.95 (95% CI, 2.78-5.63) for the presence of one comorbidity and 9.51 (95% CI, 5.62-16.06) for ≥2 comorbidities. Key risk factors included cardiovascular and neurological disorders, chronic pulmonary conditions (excluding asthma), diabetes, obesity, and immunocompromise, all with statistically significant ORs > 2.00.
conclusionsWhile the absolute risk for critical COVID-19 in children and adolescents without underlying health conditions is relatively low, the presence of one or more comorbidities was associated with markedly increased risk. These findings support the importance of risk stratification in tailoring pediatric COVID-19 management.
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