Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children's Hospital in New York City, New York.
Identifieur interne : 001520 ( Main/Corpus ); précédent : 001519; suivant : 001521Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children's Hospital in New York City, New York.
Auteurs : Philip Zachariah ; Candace L. Johnson ; Katia C. Halabi ; Danielle Ahn ; Anita I. Sen ; Avital Fischer ; Sumeet L. Banker ; Mirna Giordano ; Christina S. Manice ; Rebekah Diamond ; Taylor B. Sewell ; Adam J. Schweickert ; John R. Babineau ; R Colin Carter ; Daniel B. Fenster ; Jordan S. Orange ; Teresa A. Mccann ; Steven G. Kernie ; Lisa SaimanSource :
- JAMA pediatrics [ 2168-6211 ] ; 2020.
English descriptors
- KwdEn :
- Adolescent (MeSH), COVID-19 (MeSH), Child (MeSH), Child, Preschool (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Female (MeSH), Hospitalization (MeSH), Hospitals, Pediatric (MeSH), Humans (MeSH), Infant (MeSH), Infant, Newborn (MeSH), Male (MeSH), New York City (epidemiology), Pandemics (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (epidemiology), Retrospective Studies (MeSH), Severity of Illness Index (MeSH), Young Adult (MeSH).
- MESH :
- geographic , epidemiology : New York City.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- Adolescent, COVID-19, Child, Child, Preschool, Female, Hospitalization, Hospitals, Pediatric, Humans, Infant, Infant, Newborn, Male, Pandemics, Retrospective Studies, Severity of Illness Index, Young Adult.
Abstract
Importance
Descriptions of the coronavirus disease 2019 (COVID-19) experience in pediatrics will help inform clinical practices and infection prevention and control for pediatric facilities.
Objective
To describe the epidemiology, clinical, and laboratory features of patients with COVID-19 hospitalized at a children's hospital and to compare these parameters between patients hospitalized with and without severe disease.
Design, Setting, and Participants
This retrospective review of electronic medical records from a tertiary care academically affiliated children's hospital in New York City, New York, included hospitalized children and adolescents (≤21 years) who were tested based on suspicion for COVID-19 between March 1 to April 15, 2020, and had positive results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Exposures
Detection of SARS-CoV-2 from a nasopharyngeal specimen using a reverse transcription-polymerase chain reaction assay.
Main Outcomes and Measures
Severe disease as defined by the requirement for mechanical ventilation.
Results
Among 50 patients, 27 (54%) were boys and 25 (50%) were Hispanic. The median days from onset of symptoms to admission was 2 days (interquartile range, 1-5 days). Most patients (40 [80%]) had fever or respiratory symptoms (32 [64%]), but 3 patients (6%) with only gastrointestinal tract presentations were identified. Obesity (11 [22%]) was the most prevalent comorbidity. Respiratory support was required for 16 patients (32%), including 9 patients (18%) who required mechanical ventilation. One patient (2%) died. None of 14 infants and 1 of 8 immunocompromised patients had severe disease. Obesity was significantly associated with mechanical ventilation in children 2 years or older (6 of 9 [67%] vs 5 of 25 [20%]; P = .03). Lymphopenia was commonly observed at admission (36 [72%]) but did not differ significantly between those with and without severe disease. Those with severe disease had significantly higher C-reactive protein (median, 8.978 mg/dL [to convert to milligrams per liter, multiply by 10] vs 0.64 mg/dL) and procalcitonin levels (median, 0.31 ng/mL vs 0.17 ng/mL) at admission (P < .001), as well as elevated peak interleukin 6, ferritin, and D-dimer levels during hospitalization. Hydroxychloroquine was administered to 15 patients (30%) but could not be completed for 3. Prolonged test positivity (maximum of 27 days) was observed in 4 patients (8%).
Conclusions and Relevance
In this case series study of children and adolescents hospitalized with COVID-19, the disease had diverse manifestations. Infants and immunocompromised patients were not at increased risk of severe disease. Obesity was significantly associated with disease severity. Elevated inflammatory markers were seen in those with severe disease.
DOI: 10.1001/jamapediatrics.2020.2430
PubMed: 32492092
PubMed Central: PMC7270880
Links to Exploration step
pubmed:32492092Le document en format XML
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Johnson</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Halabi, Katia C" sort="Halabi, Katia C" uniqKey="Halabi K" first="Katia C" last="Halabi">Katia C. 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Schweickert</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Babineau, John R" sort="Babineau, John R" uniqKey="Babineau J" first="John R" last="Babineau">John R. Babineau</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Carter, R Colin" sort="Carter, R Colin" uniqKey="Carter R" first="R Colin" last="Carter">R Colin Carter</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Fenster, Daniel B" sort="Fenster, Daniel B" uniqKey="Fenster D" first="Daniel B" last="Fenster">Daniel B. Fenster</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Orange, Jordan S" sort="Orange, Jordan S" uniqKey="Orange J" first="Jordan S" last="Orange">Jordan S. Orange</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Mccann, Teresa A" sort="Mccann, Teresa A" uniqKey="Mccann T" first="Teresa A" last="Mccann">Teresa A. Mccann</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Kernie, Steven G" sort="Kernie, Steven G" uniqKey="Kernie S" first="Steven G" last="Kernie">Steven G. Kernie</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Saiman, Lisa" sort="Saiman, Lisa" uniqKey="Saiman L" first="Lisa" last="Saiman">Lisa Saiman</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32492092</idno><idno type="pmid">32492092</idno><idno type="doi">10.1001/jamapediatrics.2020.2430</idno><idno type="pmc">PMC7270880</idno><idno type="wicri:Area/Main/Corpus">001520</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001520</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children's Hospital in New York City, New York.</title><author><name sortKey="Zachariah, Philip" sort="Zachariah, Philip" uniqKey="Zachariah P" first="Philip" last="Zachariah">Philip Zachariah</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Johnson, Candace L" sort="Johnson, Candace L" uniqKey="Johnson C" first="Candace L" last="Johnson">Candace L. Johnson</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Halabi, Katia C" sort="Halabi, Katia C" uniqKey="Halabi K" first="Katia C" last="Halabi">Katia C. Halabi</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Ahn, Danielle" sort="Ahn, Danielle" uniqKey="Ahn D" first="Danielle" last="Ahn">Danielle Ahn</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Sen, Anita I" sort="Sen, Anita I" uniqKey="Sen A" first="Anita I" last="Sen">Anita I. Sen</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Fischer, Avital" sort="Fischer, Avital" uniqKey="Fischer A" first="Avital" last="Fischer">Avital Fischer</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Banker, Sumeet L" sort="Banker, Sumeet L" uniqKey="Banker S" first="Sumeet L" last="Banker">Sumeet L. Banker</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Giordano, Mirna" sort="Giordano, Mirna" uniqKey="Giordano M" first="Mirna" last="Giordano">Mirna Giordano</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Manice, Christina S" sort="Manice, Christina S" uniqKey="Manice C" first="Christina S" last="Manice">Christina S. Manice</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Diamond, Rebekah" sort="Diamond, Rebekah" uniqKey="Diamond R" first="Rebekah" last="Diamond">Rebekah Diamond</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Sewell, Taylor B" sort="Sewell, Taylor B" uniqKey="Sewell T" first="Taylor B" last="Sewell">Taylor B. Sewell</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Schweickert, Adam J" sort="Schweickert, Adam J" uniqKey="Schweickert A" first="Adam J" last="Schweickert">Adam J. Schweickert</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Babineau, John R" sort="Babineau, John R" uniqKey="Babineau J" first="John R" last="Babineau">John R. Babineau</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Carter, R Colin" sort="Carter, R Colin" uniqKey="Carter R" first="R Colin" last="Carter">R Colin Carter</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Fenster, Daniel B" sort="Fenster, Daniel B" uniqKey="Fenster D" first="Daniel B" last="Fenster">Daniel B. Fenster</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Orange, Jordan S" sort="Orange, Jordan S" uniqKey="Orange J" first="Jordan S" last="Orange">Jordan S. Orange</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Mccann, Teresa A" sort="Mccann, Teresa A" uniqKey="Mccann T" first="Teresa A" last="Mccann">Teresa A. Mccann</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Kernie, Steven G" sort="Kernie, Steven G" uniqKey="Kernie S" first="Steven G" last="Kernie">Steven G. Kernie</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Saiman, Lisa" sort="Saiman, Lisa" uniqKey="Saiman L" first="Lisa" last="Saiman">Lisa Saiman</name><affiliation><nlm:affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</nlm:affiliation></affiliation></author></analytic><series><title level="j">JAMA pediatrics</title><idno type="eISSN">2168-6211</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>COVID-19 (MeSH)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (epidemiology)</term><term>Female (MeSH)</term><term>Hospitalization (MeSH)</term><term>Hospitals, Pediatric (MeSH)</term><term>Humans (MeSH)</term><term>Infant (MeSH)</term><term>Infant, Newborn (MeSH)</term><term>Male (MeSH)</term><term>New York City (epidemiology)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (epidemiology)</term><term>Retrospective Studies (MeSH)</term><term>Severity of Illness Index (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>New York City</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>COVID-19</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Hospitalization</term><term>Hospitals, Pediatric</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term><term>Pandemics</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Importance</b></p><p>Descriptions of the coronavirus disease 2019 (COVID-19) experience in pediatrics will help inform clinical practices and infection prevention and control for pediatric facilities.</p></div><div type="abstract" xml:lang="en"><p><b>Objective</b></p><p>To describe the epidemiology, clinical, and laboratory features of patients with COVID-19 hospitalized at a children's hospital and to compare these parameters between patients hospitalized with and without severe disease.</p></div><div type="abstract" xml:lang="en"><p><b>Design, Setting, and Participants</b></p><p>This retrospective review of electronic medical records from a tertiary care academically affiliated children's hospital in New York City, New York, included hospitalized children and adolescents (≤21 years) who were tested based on suspicion for COVID-19 between March 1 to April 15, 2020, and had positive results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).</p></div><div type="abstract" xml:lang="en"><p><b>Exposures</b></p><p>Detection of SARS-CoV-2 from a nasopharyngeal specimen using a reverse transcription-polymerase chain reaction assay.</p></div><div type="abstract" xml:lang="en"><p><b>Main Outcomes and Measures</b></p><p>Severe disease as defined by the requirement for mechanical ventilation.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Among 50 patients, 27 (54%) were boys and 25 (50%) were Hispanic. The median days from onset of symptoms to admission was 2 days (interquartile range, 1-5 days). Most patients (40 [80%]) had fever or respiratory symptoms (32 [64%]), but 3 patients (6%) with only gastrointestinal tract presentations were identified. Obesity (11 [22%]) was the most prevalent comorbidity. Respiratory support was required for 16 patients (32%), including 9 patients (18%) who required mechanical ventilation. One patient (2%) died. None of 14 infants and 1 of 8 immunocompromised patients had severe disease. Obesity was significantly associated with mechanical ventilation in children 2 years or older (6 of 9 [67%] vs 5 of 25 [20%]; P = .03). Lymphopenia was commonly observed at admission (36 [72%]) but did not differ significantly between those with and without severe disease. Those with severe disease had significantly higher C-reactive protein (median, 8.978 mg/dL [to convert to milligrams per liter, multiply by 10] vs 0.64 mg/dL) and procalcitonin levels (median, 0.31 ng/mL vs 0.17 ng/mL) at admission (P < .001), as well as elevated peak interleukin 6, ferritin, and D-dimer levels during hospitalization. Hydroxychloroquine was administered to 15 patients (30%) but could not be completed for 3. Prolonged test positivity (maximum of 27 days) was observed in 4 patients (8%).</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions and Relevance</b></p><p>In this case series study of children and adolescents hospitalized with COVID-19, the disease had diverse manifestations. Infants and immunocompromised patients were not at increased risk of severe disease. Obesity was significantly associated with disease severity. Elevated inflammatory markers were seen in those with severe disease.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32492092</PMID><DateCompleted><Year>2020</Year><Month>11</Month><Day>12</Day></DateCompleted><DateRevised><Year>2021</Year><Month>03</Month><Day>24</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2168-6211</ISSN><JournalIssue CitedMedium="Internet"><Volume>174</Volume><Issue>10</Issue><PubDate><Year>2020</Year><Month>Oct</Month><Day>01</Day></PubDate></JournalIssue><Title>JAMA pediatrics</Title><ISOAbbreviation>JAMA Pediatr</ISOAbbreviation></Journal><ArticleTitle>Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children's Hospital in New York City, New York.</ArticleTitle><Pagination><MedlinePgn>e202430</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1001/jamapediatrics.2020.2430</ELocationID><Abstract><AbstractText Label="Importance" NlmCategory="UNASSIGNED">Descriptions of the coronavirus disease 2019 (COVID-19) experience in pediatrics will help inform clinical practices and infection prevention and control for pediatric facilities.</AbstractText><AbstractText Label="Objective" NlmCategory="UNASSIGNED">To describe the epidemiology, clinical, and laboratory features of patients with COVID-19 hospitalized at a children's hospital and to compare these parameters between patients hospitalized with and without severe disease.</AbstractText><AbstractText Label="Design, Setting, and Participants" NlmCategory="UNASSIGNED">This retrospective review of electronic medical records from a tertiary care academically affiliated children's hospital in New York City, New York, included hospitalized children and adolescents (≤21 years) who were tested based on suspicion for COVID-19 between March 1 to April 15, 2020, and had positive results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).</AbstractText><AbstractText Label="Exposures" NlmCategory="UNASSIGNED">Detection of SARS-CoV-2 from a nasopharyngeal specimen using a reverse transcription-polymerase chain reaction assay.</AbstractText><AbstractText Label="Main Outcomes and Measures" NlmCategory="UNASSIGNED">Severe disease as defined by the requirement for mechanical ventilation.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">Among 50 patients, 27 (54%) were boys and 25 (50%) were Hispanic. The median days from onset of symptoms to admission was 2 days (interquartile range, 1-5 days). Most patients (40 [80%]) had fever or respiratory symptoms (32 [64%]), but 3 patients (6%) with only gastrointestinal tract presentations were identified. Obesity (11 [22%]) was the most prevalent comorbidity. Respiratory support was required for 16 patients (32%), including 9 patients (18%) who required mechanical ventilation. One patient (2%) died. None of 14 infants and 1 of 8 immunocompromised patients had severe disease. Obesity was significantly associated with mechanical ventilation in children 2 years or older (6 of 9 [67%] vs 5 of 25 [20%]; P = .03). Lymphopenia was commonly observed at admission (36 [72%]) but did not differ significantly between those with and without severe disease. Those with severe disease had significantly higher C-reactive protein (median, 8.978 mg/dL [to convert to milligrams per liter, multiply by 10] vs 0.64 mg/dL) and procalcitonin levels (median, 0.31 ng/mL vs 0.17 ng/mL) at admission (P < .001), as well as elevated peak interleukin 6, ferritin, and D-dimer levels during hospitalization. Hydroxychloroquine was administered to 15 patients (30%) but could not be completed for 3. Prolonged test positivity (maximum of 27 days) was observed in 4 patients (8%).</AbstractText><AbstractText Label="Conclusions and Relevance" NlmCategory="UNASSIGNED">In this case series study of children and adolescents hospitalized with COVID-19, the disease had diverse manifestations. Infants and immunocompromised patients were not at increased risk of severe disease. Obesity was significantly associated with disease severity. Elevated inflammatory markers were seen in those with severe disease.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Zachariah</LastName><ForeName>Philip</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Johnson</LastName><ForeName>Candace L</ForeName><Initials>CL</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Halabi</LastName><ForeName>Katia C</ForeName><Initials>KC</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ahn</LastName><ForeName>Danielle</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sen</LastName><ForeName>Anita I</ForeName><Initials>AI</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fischer</LastName><ForeName>Avital</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Banker</LastName><ForeName>Sumeet L</ForeName><Initials>SL</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Giordano</LastName><ForeName>Mirna</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Manice</LastName><ForeName>Christina S</ForeName><Initials>CS</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Diamond</LastName><ForeName>Rebekah</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sewell</LastName><ForeName>Taylor B</ForeName><Initials>TB</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schweickert</LastName><ForeName>Adam J</ForeName><Initials>AJ</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Babineau</LastName><ForeName>John R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carter</LastName><ForeName>R Colin</ForeName><Initials>RC</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fenster</LastName><ForeName>Daniel B</ForeName><Initials>DB</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Orange</LastName><ForeName>Jordan S</ForeName><Initials>JS</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McCann</LastName><ForeName>Teresa A</ForeName><Initials>TA</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kernie</LastName><ForeName>Steven G</ForeName><Initials>SG</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Saiman</LastName><ForeName>Lisa</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Columbia Pediatric COVID-19 Management Group</CollectiveName></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>L30 AI133789</GrantID><Acronym>AI</Acronym><Agency>NIAID NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType 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