Risk factors for COVID-19 mortality among children and adolescents in Rio de Janeiro state, 2020-2023

Read the full article See related articles

Listed in

This article is not in any list yet, why not save it to one of your lists.
Log in to save this article

Abstract

Background Children and adolescents with COVID-19 typically present milder symptoms of the infection, with fatal outcomes being rare. This study aimed to analyze the main risk factors for mortality in this population group. Methods A cross-sectional study was performed to analyze reported COVID-19 cases among individuals under 18 years old in Rio de Janeiro state, Brazil, from March 2021 to September 2023. Pearson's chi-square test was used for categorical variables, and the Wilcoxon test for numerical variables. The significance level was set at 5%. Logistic regression analysis was performed to identify factors associated with COVID-19 mortality in individuals under 18. Results Infants under 1 year old had a higher mortality risk (OR = 4.70; 95% CI: 2.45–9.60) compared to adolescents aged 15–17 years. Non-white individuals had a lower mortality risk compared to white individuals (OR = 0.64; 95% CI: 0.41–0.99). The presence of fever (OR = 1.83; 95% CI: 1.17–2.89), dyspnea (OR = 11.83; 95% CI: 7.50-18.74), and oxygen saturation below 95% (OR = 11.97; 95% CI: 3.78–33.19) was associated with a higher mortality risk. Patients with heart disease (OR = 7.74; 95% CI: 3.89–14.58) and immunodeficiency/immunosuppression (OR = 17.16; 95% CI: 8.58–32.14) had a higher mortality risk. Infection during the predominance of variants B1_wild (OR = 3.44; CI 1.75–6.81), Gamma (OR = 3.93; CI 2.13–7.44), and Delta (OR = 2.27; CI 1.02–4.84) was associated with a higher mortality risk compared to the Omicron variant. Conclusions The main risk factors for death were fever, dyspnea, oxygen saturation below 95% on room air, age under one year, cardiac disease comorbidity, immunodeficiency, and infection during the predominance of B1_wild, Gamma, and Delta variants. Understanding the epidemiological profile and risk factors for mortality in this population is essential to inform effective prevention and control measures and guide optimal clinical management.

Article activity feed