Identifying which children and young people (CYP) are most vulnerable to serious infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to guide protective interventions. To address this question, we used data for all hospitalizations in England among 0–17 year olds from 1 February 2019 to 31 January 2021. We examined how sociodemographic factors and comorbidities might be risk factors for pediatric intensive care unit (PICU) admission among hospitalizations due to the following causes: Coronavirus Disease 2019 (COVID-19) and pediatric inflammatory multi-system syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the first pandemic year (2020–2021); hospitalizations due to all other non-traumatic causes in 2020–2021; hospitalizations due to all non-traumatic causes in 2019–2020; and hospitalizations due to influenza in 2019–2020. Risk of PICU admission and death from COVID-19 or PIMS-TS in CYP was very low. We identified 6,338 hospitalizations with COVID-19, of which 259 were admitted to a PICU and eight CYP died. We identified 712 hospitalizations with PIMS-TS, of which 312 were admitted to a PICU and fewer than five CYP died. Hospitalizations with COVID-19 and PIMS-TS were more common among males, older CYP, those from socioeconomically deprived neighborhoods and those who were of non-White ethnicity (Black, Asian, Mixed or Other). The odds of PICU admission were increased in CYP younger than 1 month old and decreased among 15–17 year olds compared to 1–4 year olds with COVID-19; increased in older CYP and females with PIMS-TS; and increased for Black compared to White ethnicity in patients with COVID-19 and PIMS-TS. Odds of PICU admission in COVID-19 were increased for CYP with comorbidities and highest for CYP with multiple medical problems. Increases in odds of PICU admission associated with different comorbidities in COVID-19 showed a similar pattern to other causes of hospitalization examined and, thus, likely reflect background vulnerabilities. These findings identify distinct risk factors associated with PICU admission among CYP with COVID-19 or PIMS-TS that might aid treatment and prevention strategies.

确定哪些儿童和青少年 (CYP) 最容易受到严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 的严重感染，对于指导保护性干预措施非常重要。为了解决这个问题，我们使用了 2019 年 2 月 1 日至 2021 年 1 月 31 日期间英格兰 0-17 岁所有住院患者的数据。我们研究了社会人口因素和合并症如何成为儿科重症监护病房 (PICU) 住院患者的风险因素由于以下原因：在第一个大流行年（2020-2021 年）与 SARS-CoV-2 (PIMS-TS) 暂时相关的 2019 年冠状病毒病 (COVID-19) 和小儿炎症性多系统综合征；2020-2021 年因所有其他非创伤性原因住院；2019-2020 年因所有非创伤性原因住院；2019-2020 年因流感住院。CYP 患者因 COVID-19 或 PIMS-TS 进入 PICU 和死亡的风险非常低。我们确定了 6,338 例 COVID-19 住院患者，其中 259 例被送入 PICU，8 例 CYP 死亡。我们确定了 712 例 PIMS-TS 住院治疗，其中 312 例被送入 PICU，不到 5 例 CYP 死亡。COVID-19 和 PIMS-TS 住院在男性、老年 CYP、来自社会经济贫困社区的人以及非白人种族（黑人、亚洲人、混血或其他人）中更为常见。与患有 COVID-19 的 1-4 岁儿童相比，1 个月以下 CYP 患者入院 PICU 的几率增加，而 15-17 岁儿童入院几率降低；老年 CYP 和 PIMS-TS 女性增加；在 COVID-19 和 PIMS-TS 患者中，黑人与白人相比有所增加。有合并症的 CYP 患者在 COVID-19 中入院 PICU 的几率增加，而有多种医疗问题的 CYP 患者入院几率最高。与 COVID-19 中不同合并症相关的 PICU 入院几率的增加与所检查的其他住院原因相似，因此可能反映了背景脆弱性。这些发现确定了与 COVID-19 或 PIMS-TS 的 CYP 入院相关的不同风险因素，这可能有助于治疗和预防策略。