• Olivier Drouin, Charlotte Moore Hepburn, Daniel S Farrar, Krista Baerg, Kevin Chan, Claude Cyr, Elizabeth J Donner, Joanne E Embree, Catherine Farrell, Sarah Forgie, Ryan Giroux, Kristopher T Kang, Melanie King, Melanie Laffin, Thuy Mai Luu, Julia Orkin, Jesse Papenburg, Catherine M Pound, Victoria E Price, Rupeena Purewal, Manish Sadarangani, Marina I Salvadori, Karina A Top, Isabelle Viel-Thériault, Fatima Kakkar, Shaun K Morris, and Canadian Paediatric Surveillance Program COVID-19 Study Team.
• Divisions of General Pediatrics (Drouin, Luu) and Pediatric Intensive Care (Farrell), Department of Pediatrics, and Division of Infectious Diseases (Kakkar), Centre Hospitalier Universitaire Sainte-Justine; Department of Social and Preventive Medicine (Drouin), School of Public Health, Université de Montréal, Montréal, Que.; Division of Paediatric Medicine (Moore Hepburn, Giroux, Orkin), Centre for Global Child Health (Farrar, Morris) and Child Health Evaluative Sciences (Morris, Orkin), The Hospital for Sick Children; Institute of Health Policy, Management and Evaluation (Moore Hepburn), and Departments of Pediatrics (Chan) and Clinical Public Health (Morris), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Department of Pediatrics (Baerg, Purewal), University of Saskatchewan; Divisions of General Paediatrics (Baerg) and Pediatric Infectious Diseases (Purewal), Jim Pattison Children's Hospital, Saskatchewan Health Authority, Saskatoon, Sask.; Department of Children's and Women's Health (Chan), Trillium Health Partners, Mississauga, Ont.; Service de soins intensifs pédiatriques (Cyr), Centre Hospitalier, and Faculté de médecine (Cyr), Université de Sherbrooke, Sherbrooke, Que.; Departments of Paediatrics and Child Health (Embree), and Medical Microbiology and Infectious Diseases (Embree), University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Forgie), Department of Pediatrics, University of Alberta; Stollery Children's Hospital (Forgie), Edmonton, Alta.; Department of Pediatrics (Sadarangani, Tang), University of British Columbia, Vancouver, BC; Canadian Paediatric Surveillance Program (King, Laffin), Canadian Paediatric Society, Ottawa, Ottawa, Ont.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of General Pediatrics (Pound), Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Pediatric Hematology/Oncology (Price), Department of Pediatrics, Dalhousie University, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute, Vancouver, BC; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Department of Pediatrics (Top), Dalhousie University, Halifax, NS; Division of Infectious Diseases (Viel-Thériault), Department of Pediatrics, CHU de Québec-Université Laval, Québec, Que.; Divisions of Infectious Diseases (Morris) and Neurology (Donner), The Hospital for Sick Children; University of Toronto, Toronto, Ont.
• CMAJ. 2021 Sep 27; 193 (38): E1483-E1493.

BackgroundRisk factors for severe outcomes of SARS-CoV-2 infection are not well established in children. We sought to describe pediatric hospital admissions associated with SARS-CoV-2 infection in Canada and identify risk factors for more severe disease.MethodsWe conducted a national prospective study using the infrastructure of the Canadian Paediatric Surveillance Program (CPSP). Cases involving children who were admitted to hospital with microbiologically confirmed SARS-CoV-2 infection were reported from Apr. 8 to Dec. 31 2020, through weekly online questionnaires distributed to the CPSP network of more than 2800 pediatricians. We categorized hospital admissions as related to COVID-19, incidental, or for social or infection control reasons and determined risk factors for disease severity in hospital.ResultsAmong 264 hospital admissions involving children with SARS-CoV-2 infection during the 9-month study period, 150 (56.8%) admissions were related to COVID-19 and 100 (37.9%) were incidental infections (admissions for other reasons and found to be positive for SARS-CoV-2 on screening). Infants (37.3%) and adolescents (29.6%) represented most cases. Among hospital admissions related to COVID-19, 52 (34.7%) had critical disease, 42 (28.0%) of whom required any form of respiratory or hemodynamic support, and 59 (39.3%) had at least 1 underlying comorbidity. Children with obesity, chronic neurologic conditions or chronic lung disease other than asthma were more likely to have severe or critical COVID-19.InterpretationAmong children who were admitted to hospital with SARS-CoV-2 infection in Canada during the early COVID-19 pandemic period, incidental SARS-CoV-2 infection was common. In children admitted with acute COVID-19, obesity and neurologic and respiratory comorbidities were associated with more severe disease.© 2021 CMA Joule Inc. or its licensors.

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