Hospitalization of Infants and Children Aged 0-4 Years with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 2020-February 2022

Abstract

The B.1.1.529 (Omicron) variant of SARS-CoV-2, the virus that causes COVID-19, has been the predominant circulating variant in the United States since late December 2021.* Coinciding with increased Omicron circulation, COVID-19-associated hospitalization rates increased rapidly among infants and children aged 0-4 years, a group not yet eligible for vaccination (1). Coronavirus Disease 19-Associated Hospitalization Surveillance Network (COVID-NET)† data were analyzed to describe COVID-19-associated hospitalizations among U.S. infants and children aged 0-4 years since March 2020. During the period of Omicron predominance (December 19, 2021-February 19, 2022), weekly COVID-19-associated hospitalization rates per 100,000 infants and children aged 0-4 years peaked at 14.5 (week ending January 8, 2022); this Omicron-predominant period peak was approximately five times that during the period of SARS-CoV-2 B.1.617.2 (Delta) predominance (June 27-December 18, 2021, which peaked the week ending September 11, 2021).§ During Omicron predominance, 63% of hospitalized infants and children had no underlying medical conditions; infants aged <6 months accounted for 44% of hospitalizations, although no differences were observed in indicators of severity by age. Strategies to prevent COVID-19 among infants and young children are important and include vaccination among currently eligible populations (2) such as pregnant women (3), family members, and caregivers of infants and young children (4).

Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Evan J. Anderson reports grants from Pfizer, Merck, PaxVax, Micron, Sanofi-Pasteur, Janssen, MedImmune, and GlaxoSmithKline; personal fees from Pfizer, Medscape, Kentucky Bioprocessing, Inc., Sanofi-Pasteur, and Janssen, outside the submitted work; and institutional funding from the National Institutes of Health to conduct clinical trials of Moderna and Janssen COVID-19 vaccines. Eli Shiltz, Andy Weigel, Sue Kim, and Andrea Price report grants from the Council of State and Territorial Epidemiologists during the conduct of the study. Sue Kim reports grants from the Michigan Department of Health and Human Services during the conduct of the study. Ruth Lynfield reports editorial payments from the American Academy of Pediatrics Red Book (Committee on Infectious Diseases), which were donated to the Minnesota Department of Health. No other potential conflicts of interest were disclosed.

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COVID-19–associated hospitalization rates among infants and children aged 0–4 years, by age group (3-week moving average) — Coronavirus Disease 2019–Associated Hospitalization Surveillance Network, 14 states, March 2020–February 2022 Abbreviation: COVID-NET = Coronavirus Disease 2019–Associated Hospitalization Surveillance Network. * Number of patients with laboratory-confirmed COVID-19–associated hospitalizations per 100,000 population; rates are subject to change as additional data are reported. † COVID-NET sites are in the following 14 states: California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah. Starting the week ending December 4, 2021, Maryland data are removed from weekly rate calculations. § Periods of predominance are defined as follows: pre-Delta = March 1, 2020–June 26, 2021; Delta = June 27–December 18, 2021; Omicron = December 19, 2021–February 19, 2022.