Abstract
BACKGROUND: Previous studies of severe acute respiratory syndrome coronavirus 2 infection in infants have incompletely characterized factors associated with severe illness or focused on infants born to mothers with coronavirus disease 2019 (COVID-19). Here we highlight demographics, clinical characteristics and laboratory values that differ between infants with and without severe acute COVID-19. METHODS: Active surveillance was performed by the Overcoming COVID-19 network to identify children and adolescents with severe acute respiratory syndrome coronavirus 2-related illness hospitalized at 62 sites in 31 states from March 15 to December 27, 2020. We analyzed patients >7 days to <1 year old hospitalized with symptomatic acute covid-19. results: we report 232 infants>7 days to <1 year of age hospitalized with acute symptomatic covid-19 from 37 us hospitals in our cohort from march 15 to december 27, 2020. among 630 cases of severe covid-19 in patients>7 days to <18 years old, 128 (20.3%) were infants. in infants with severe illness from the entire study period, the median age was 2 months, 66% were from racial and ethnic minority groups, 66% were previously healthy, 73% had respiratory complications, 13% received mechanical ventilation and><1% died. conclusions: infants accounted for over a fifth of children><18 years of age hospitalized for severe acute covid-19, commonly manifesting with respiratory symptoms and complications. although most infants hospitalized with covid-19 did not suffer significant complications, longer term outcomes remain unclear. notably, 75% of infants with severe disease were><6 months of age in this cohort study period, which predated maternal covid-19 vaccination, underscoring the importance of maternal vaccination for covid-19 in protecting the mother and infant.>
