Introduction: Though severe illness due to COVID-19 is uncommon in children, there is an urgent need to better determine the risk factors for disease severity in youth. This study aims to determine the impact a preexisting endocrine diagnosis has on severity of COVID-19 presentation in youth. Methods: Cross-sectional chart review study included all patients less than 25 years old with a positive SARS-CoV-2 PCR at St. Louis Children’s Hospital between March 2020 and February 2021. Electronic medical record data for analysis included: patient demographics, BMI percentile, inpatient hospitalization or admission to the pediatric intensive care unit, presence of a preexisting endocrine diagnosis such as: diabetes mellitus (Type 1 and Type 2), adrenal insufficiency, and hypothyroidism. Two outcome measures were analyzed in multivariate analysis: inpatient admission and PICU admission. Adjusted Odds ratios with 95% CI were calculated using binary logistic regression, along with p values after Wald Chi-Square analysis. Results: 390 patients were included in the study. Mean age 123.1 (+ 82.2) months old. 50.3% of patients were hospitalized, and 12.1% of patients were admitted to intensive care. Preexisting diagnosis of diabetes mellitus, obesity, and hypothyroidism were associated with an increased risk of hospital and ICU admission, independent of socioeconomic status. Discussion/Conclusion: This study provides evidence that unvaccinated youth with a preexisting diagnosis of obesity, hypothyroidism, or diabetes mellitus infected with COVID-19 are more likely to have a more severe clinical presentation requiring inpatient hospital admission and/or intensive care.


中文翻译：

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儿科患者内分泌紊乱与严重 COVID-19 疾病之间的关联


介绍： 尽管儿童中由 COVID-19 引起的严重疾病并不常见，但迫切需要更好地确定青少年疾病严重程度的危险因素。本研究旨在确定既往内分泌诊断对青少年 COVID-19 表现严重程度的影响。 方法： 横断面图表审查研究包括 2020 年 3 月至 2021 年 2 月期间圣路易斯儿童医院 SARS-CoV-2 PCR 呈阳性的所有 25 岁以下患者。用于分析的电子病历数据包括：患者人口统计数据、BMI 百分位、住院或入住儿科重症监护病房、已有内分泌诊断，例如：糖尿病（1 型和 2 型）、肾上腺功能不全和甲状腺功能减退症。多变量分析中分析了两种结果指标：住院患者入院和 PICU 入院。使用二元逻辑回归以及 Wald 卡方分析后的 p 值计算调整后的优势比（95% CI）。 结果： 该研究纳入了 390 名患者。平均年龄 123.1 (+ 82.2) 个月。 50.3%的患者住院治疗，12.1%的患者住进重症监护室。既往诊断的糖尿病、肥胖症和甲状腺功能减退症与住院和入住 ICU 的风险增加相关，与社会经济状况无关。讨论/结论： 这项研究提供的证据表明，先前诊断为肥胖、甲状腺功能减退或感染了 COVID-19 的糖尿病的未接种疫苗的青少年更有可能出现更严重的临床表现，需要住院和/或重症监护。