Number of U.S. kids hospitalized with COVID-19 is likely overcounted, study says

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The actual number of U.S. children hospitalized due to COVID-19 may be lower than current figures suggest, a new study indicates.

That's because counts of hospitalized children who test positive for COVID-19 may include those who were admitted for other reasons and have no COVID-19 symptoms, Stanford University School of Medicine researchers explained.


Throughout the pandemic, children have been admitted to hospitals for problems ranging from broken bones and appendicitis to cancer. When they arrive at the hospital and are tested for COVID-19, some turn out to be infected.

But many who test positive never develop symptoms, according to the study.

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"It's really important that we distinguish between children who are hospitalized with asymptomatic [COVID-19] infections and those hospitalized for COVID-19 disease," said study co-author Dr. Alan Schroeder, a clinical professor of pediatric critical care and of pediatric hospital medicine.

"Our goal is to make sure we have accurate data on how sick children are getting," he said in a Stanford news release. "If we rely on hospitals' positive [COVID-19] test results, we are inflating by about twofold the actual risk of hospitalization from the disease in kids."

The researchers analyzed COVID-19 data from Lucile Packard Children's Hospital Stanford between May 10, 2020 and Feb. 10, 2021.

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They found that 117 children either tested positive for the virus or were hospitalized for MIS-C, a potentially serious inflammatory syndrome that can occur in infected children.

Of the 117 patients, 39% had asymptomatic COVID-19. Another 28% had mild to moderate illness, about 8% had severe illness, roughly 13% had critical illness and 12% had MIS-C.

Patients with mild to moderate illness did not require supplemental oxygen, those with severe illness needed oxygen but not ventilation, and those with critical illness needed ventilation and may have had sepsis or multi-organ failure.

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Of the 117 patients, close to half -- 53 -- were admitted to the hospital for reasons unrelated to the virus, the researchers found.

The percentage of positive tests in a children's hospital is a better measure of COVID-19's prevalence in the community than the rate of COVID-19 illness in children, according to study senior author Dr. Roshni Mathew, clinical associate professor of pediatric infectious diseases.

"The higher the prevalence, the higher the likelihood that anyone who has to come to the hospital is going to test positive," she said in the release. "Just knowing that a child is hospitalized and has the virus is not enough information to determine if they are actually sick with COVID-19."


The findings could be used to improve the accuracy of public health records for COVID-19, according to the researchers.

The study was published online Wednesday in the journal Hospital Pediatrics.

More information

The American Academy of Pediatrics has more on COVID-19.

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