COVID-19 Roundup: Pediatric Hospitalizations, Booster Effectiveness, Mental Health, Health Care Delays
Hospitalization In Pediatric Populations1
Hospitalizations for COVID-19 infections among children and adolescents aged 17 years or younger have increased rapidly during the recent omicron variant surge, according to the results of a recent study by the Centers for Disease Control and Prevention (CDC).
The researchers utilized data from the Coronavirus Disease 19-Associated Hospitalization Surveillance Network (COVID-NET) to compare the rates of hospitalizations among these patients during periods of delta and omicron variant predominance. Delta predominance was defined here as July 1, 2021 to December 18, 2021. Omicron predominance was defined here as December 19, 2021 to January 22, 2022.
The results indicated that the omicron variant peak was 4 times greater than the delta variant peak, at 7.1 and 1.8 per 100,000 pediatric patients, respectively. Children aged 4 years or younger had the largest increase in rates of hospitalization. Further, unvaccinated adolescents aged 12 to 17 years reported hospitalization rates that were approximately 6 times higher than those who were fully vaccinated in December 2021.
Mental Health Following COVID-19 Infection2
The results of a recent study indicate that individuals who survived after a COVID-19 infection may be at an increased risk of mental health disorders.
The researchers conducted a cohort study which included 3 groups:
- 153,848 individuals who survived for at least 30-days following a COVID-19 infection from March 1, 2020 to January 15, 2021 (COVID-19 group)
- 5,637,840 individuals who had no evidence of a COVID-19 infection (contemporary group)
- 5,859,251 individuals with data from March 2018 to January 2019, prior to the pandemic (historical control group)
Per 1000 people at 1 year, the risk of incident anxiety disorders, depressive disorders, stress and adjustment disorders, and the use of antidepressants and benzodiazepines were higher among the COVID-19 group. The risk of incident opioid prescriptions, opioid use disorder, and other non-opioid substance use disorders also increased in the COVID-19 group. This group also saw an increase in the risk of incident neurocognitive decline, sleep disorders, and any incident mental health diagnosis or prescription.
While these risks increased the highest among individuals in the COVID-19 group who required hospitalization, the risk of these outcomes were higher for individuals with COVIID-19 who did not require hospitalization as well.
Booster Effectiveness3
The effectiveness of a third dose of an mRNA COVID-19 vaccine to reduce the risk of emergency department/urgent care (ED/UC) visits and hospitalization may decrease after 4 months, according to the results of a recent study.
Included were 241,204 ED/UC visits and 93,408 hospitalizations among individuals aged 18 years or older between August 26, 2021 and January 22, 2022. All visits were to 1 of 8 sites within the VISION Network.
During the omicron variant period, the vaccine effectiveness against ED/UC visits was 87% at 2 months after administration of a third dose. By months 4 and 5 following booster administration, the vaccine effectiveness decreased to 66%. Similarly, the effectiveness against hospitalization during the omicron variant period was 91% at 2 months, and 78% at 4 or more months. The vaccine effectiveness was higher for hospitalizations than ED/UC visits for both the delta and omicron predominant periods.
Health Care Delays4
Approximately one-third of adults aged 50 years or older delayed procedures, primary care visits, or dental appointments during 2021 due to the COVID-19 pandemic, according to the results of a national poll.
Of the adults who had scheduled an appointment for a procedure, test or operation in 2021, 28% of respondents had to delay. These plans were rescheduled in 44% of unvaccinated adults, compared with 81% of vaccinated and boosted adults. Similarly, 29% of respondents delayed a primary care appointment, with 53% of unvaccinated adults, 74% of vaccinated adults, and 85% of boosted adults rescheduling their plans. Dental appointments were disrupted in 31% of respondents, with 30% of unvaccinated adults and 64% of vaccinated and boosted adults rescheduling their appointments.
“Whether they chose to postpone, or their provider did, these patients missed opportunities for preventive care and for early detection and effective management of chronic conditions, not to mention operations and procedures to address a pressing health need,” concluded researcher Jeffrey Kullgren, MD, MPH, MS. “The fact that half or more unvaccinated people have not yet rescheduled those disrupted appointments is especially concerning, because every encounter with a health care provider is also an opportunity to talk about the benefits and safety of COVID vaccination for older adults.”
—Leigh Precopio
References:
- Marks KJ, Whitaker M, Anglin O, et al. Hospitalizations of children and adolescents with laboratory-confirmed COVID-19 – COVID-NET, 14 states, July 2021-January 2022. MMWR Morb Moral Wkly Rep. 2022;71(7);271-278. https://www.cdc.gov/mmwr/volumes/71/wr/mm7107e4.htm?s_cid=mm7107e4_w
- Xie Y, Xu E, Al-Aly Z. Risks of mental health outcomes in people with COVID-19: cohort study. BMJ. Published online February 16, 2022. doi: 10.1136/bmj-2021-068993
- Ferdinands JM, Rao S, Dixon BE, et al. Waning 2-dose and 3-dose effectiveness of mRNA vaccines against COVID-19-associated emergency department and urgent care encounters and hospitalizations among adults during delta and omicron variant predominance – VISION Network, 10 states, August 2021 – January 2022. MMWR Morb Moral Wkly Rep. 2022;71(7);255-263. https://www.cdc.gov/mmwr/volumes/71/wr/mm7107e2.htm?s_cid=mm7107e2_w
- Pandemic disruptions mean many older adults still haven’t gotten needed care. News release. National Poll on Healthy Aging; February 15, 2022. Accessed February 18, 2022. https://www.healthyagingpoll.org/reports-more/poll-extras/pandemic-disruptions-mean-many-older-adults-still-havent-gotten-needed