Results identify children at potentially higher risk of severe disease who may benefit from COVID-19 prevention efforts, including vaccination. Rates of severe COVID-19 establish a baseline for monitoring changes in pediatric illness severity following increased availability of COVID-19 vaccines and the emergence of new variants.

Approximately 30% of hospitalized children had severe COVID-19 and 0.5% died during hospitalization.

Among hospitalized children aged <2 years, chronic lung disease, neurologic disorders, cardiovascular disease, prematurity and airway abnormality were associated with severe COVID-19. Among hospitalized children aged 2‒17 years, feeding tube dependence, diabetes mellitus and obesity were associated with severe COVID-19. Severe COVID-19 occurred among 12.0 per 100,000 children aged <18 years, and was highest among infants, Hispanic children, and non-Hispanic Black children.

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