Hospitalization of Adolescents Aged 12-17 Years with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 1, 2020-April 24, 2021

Abstract

Most COVID-19-associated hospitalizations occur in older adults, but severe disease that requires hospitalization occurs in all age groups, including adolescents aged 12-17 years (1). On May 10, 2021, the Food and Drug Administration expanded the Emergency Use Authorization for Pfizer-BioNTech COVID-19 vaccine to include persons aged 12-15 years, and CDC's Advisory Committee on Immunization Practices recommended it for this age group on May 12, 2021.* Before that time, COVID-19 vaccines had been available only to persons aged ≥16 years. Understanding and describing the epidemiology of COVID-19-associated hospitalizations in adolescents and comparing it with adolescent hospitalizations associated with other vaccine-preventable respiratory viruses, such as influenza, offers evidence of the benefits of expanding the recommended age range for vaccination and provides a baseline and context from which to assess vaccination impact. Using the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET), CDC examined COVID-19-associated hospitalizations among adolescents aged 12-17 years, including demographic and clinical characteristics of adolescents admitted during January 1-March 31, 2021, and hospitalization rates (hospitalizations per 100,000 persons) among adolescents during March 1, 2020-April 24, 2021. Among 204 adolescents who were likely hospitalized primarily for COVID-19 during January 1-March 31, 2021, 31.4% were admitted to an intensive care unit (ICU), and 4.9% required invasive mechanical ventilation; there were no associated deaths. During March 1, 2020-April 24, 2021, weekly adolescent hospitalization rates peaked at 2.1 per 100,000 in early January 2021, declined to 0.6 in mid-March, and then rose to 1.3 in April. Cumulative COVID-19-associated hospitalization rates during October 1, 2020-April 24, 2021, were 2.5-3.0 times higher than were influenza-associated hospitalization rates from three recent influenza seasons (2017-18, 2018-19, and 2019-20) obtained from the Influenza Hospitalization Surveillance Network (FluSurv-NET). Recent increased COVID-19-associated hospitalization rates in March and April 2021 and the potential for severe disease in adolescents reinforce the importance of continued COVID-19 prevention measures, including vaccination and correct and consistent wearing of masks by persons not yet fully vaccinated or when required by laws, rules, or regulations.^†.

FIGURE 1

Three-week moving average COVID-19–associated hospitalization rates* among children and adolescents aged <18 years, by age group — COVID-NET, 14 states,† March 1, 2020–April 24, 2021 Abbreviation: COVID-NET = Coronavirus Disease 2019–Associated Hospitalization Surveillance Network. * Number of patients with laboratory-confirmed COVID-19–associated hospitalizations per 100,000 population. ^† 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.

FIGURE 2

Cumulative rates for COVID-19–associated hospitalizations* compared with influenza-associated hospitalizations^† among adolescents aged 12–17 years, by surveillance week^§ — COVID-NET^¶ and FluSurv-NET,** 14 states,^†† 2017–2021^§§ Abbreviations: COVID-NET = Coronavirus Disease 2019–Associated Hospitalization Surveillance Network; FluSurv-NET = Influenza Hospitalization Surveillance Network. * Number of patients with laboratory-confirmed COVID-19-associated hospitalizations per 100,000 population. ^† Number of patients with laboratory-confirmed influenza-associated hospitalizations per 100,000 population. ^§ Surveillance week is based on the epidemiologic week for disease reporting and lasts Sundays through Saturdays. MMWR week numbering is sequential beginning with 1 and incrementing with each week to a maximum of 52 or 53. The three influenza seasons had no surveillance week 53, so values from surveillance week 52 were imputed to surveillance week 53. https://wwwn.cdc.gov/nndss/document/MMWR_week_overview.pdf ^¶ COVID-NET is a population-based surveillance system of laboratory-confirmed COVID-19–associated hospitalizations in 99 counties across 14 states. COVID-19–associated hospitalizations among residents in a predefined surveillance catchment area who received a positive test for SARS-CoV-2 (the virus that causes COVID-19) during hospitalization or ≤14 days before admission are included in surveillance. ** FluSurv-NET is a population-based surveillance system of laboratory-confirmed influenza-associated hospitalizations in 81 counties across 13 states (for the period included) and is conducted annually during October 1–April 30. Influenza-associated hospitalizations among residents in a predefined surveillance catchment area who received a positive test for influenza during hospitalization or ≤14 days before admission are included in surveillance. ^†† COVID-NET and FluSurv-NET sites were in the following 14 states for the period shown: California, Colorado, Connecticut, Georgia, Iowa (COVID-NET only), Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah. ^§§ Cumulative COVID-19–associated hospitalization rates among adolescents aged 12–17 years during October 1, 2020–April 24, 2021, were compared with influenza-associated hospitalization rates in the same age group during October 1–April 30 across three seasons (2017–18, 2018–19, and 2019–20) using data from FluSurv-NET.