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Table 3b. The Panel’s Framework for Assessing the Risk of Progression to Severe COVID-19 Based on Patient Conditions and COVID-19 Vaccination Status

Last Updated: August 8, 2022

Table 3b. The Panel’s Framework for Assessing the Risk of Progression to Severe COVID-19 Based on Patient Conditions and COVID-19 Vaccination Status
ConditionsRisk Level by Vaccination Statusa
UnvaccinatedPrimary SeriesUp to Date
Strong or Consistent Association With Progression to Severe COVID-19
High
  • Obesity (BMI ≥95th percentile for age), especially severe obesity (BMI ≥120% of 95th percentile for age)b
  • Medical complexity with dependence on respiratory technologyc
  • Severe neurologic, genetic, metabolic, or other disability that results in impaired airway clearance or limitations in self care or activities of daily living
  • Severe asthma or other severe chronic lung disease requiring ≥2 inhaled or ≥1 systemic medications daily
  • Severe congenital or acquired cardiac disease
  • Multiple moderate to severe chronic diseases
HighIntermediate
Moderate or Inconsistent Association With Progression to Severe COVID-19
  • Aged <1 year
  • Prematurity in children aged ≤2 years
  • Sickle cell disease
  • Diabetes mellitus (poorly controlled)
  • Nonsevere cardiac, neurologic, or metabolic diseased
Intermediate
Weak or Unknown Association With Progression to Severe COVID-19
  • Mild asthma
  • Overweight
  • Diabetes mellitus (well controlled)
Low

References

  1. Centers for Disease Control and Prevention. COVID-19 weekly cases and deaths per 100,000 population by age, race/ethnicity, and sex. 2022. Available at: https://covid.cdc.gov/covid-data-tracker/#demographicsovertime. Accessed July 26, 2022.
  2. Centers for Disease Control and Prevention. Demographic trends of COVID-19 cases and deaths in the US reported to CDC. 2022. Available at: https://covid.cdc.gov/covid-data-tracker/#demographics. Accessed July 26, 2022.
  3. Centers for Disease Control and Prevention. COVID-NET laboratory-confirmed COVID-19 hospitalizations. 2022. Available at: https://covid.cdc.gov/covid-data-tracker/#covidnet-hospitalization-network. Accessed July 26, 2022.
  4. Centers for Disease Control and Prevention. Provisional COVID-19 deaths: focus on ages 0–18 years. 2022. Available at: https://data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-Focus-on-Ages-0-18-Yea/nr4s-juj3. Accessed July 26, 2022.
  5. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145(6):e20200702. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32179660.
  6. CDC COVID-19 Response Team. Coronavirus disease 2019 in children—United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(14):422-426. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32271728.
  7. Cui X, Zhang T, Zheng J, et al. Children with coronavirus disease 2019: a review of demographic, clinical, laboratory, and imaging features in pediatric patients. J Med Virol. 2020;92(9):1501-1510. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32418216.
  8. Livingston E, Bucher K. Coronavirus disease 2019 (COVID-19) in Italy. JAMA. 2020;323(14):1335. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32181795.
  9. Tagarro A, Epalza C, Santos M, et al. Screening and severity of coronavirus disease 2019 (COVID-19) in children in Madrid, Spain. JAMA Pediatr. 2020;Published online ahead of print. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32267485.
  10. DeBiasi RL, Song X, Delaney M, et al. Severe coronavirus disease-2019 in children and young adults in the Washington, DC, metropolitan region. J Pediatr. 2020;223:199-203. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32405091.
  11. Chao JY, Derespina KR, Herold BC, et al. Clinical characteristics and outcomes of hospitalized and critically ill children and adolescents with coronavirus disease 2019 at a tertiary care medical center in New York City. J Pediatr. 2020;223:14-19. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32407719.
  12. Swann OV, Holden KA, Turtle L, et al. Clinical characteristics of children and young people admitted to hospital with COVID-19 in United Kingdom: prospective multicentre observational cohort study. BMJ. 2020;370:m3249. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32960186.
  13. Gotzinger F, Santiago-Garcia B, Noguera-Julian A, et al. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health. 2020;4(9):653-661. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32593339.
  14. Shi DS, Whitaker M, Marks KJ, et al. Hospitalizations of children aged 5–11 years with laboratory-confirmed COVID-19—COVID-NET, 14 states, March 2020–February 2022. MMWR Morb Mortal Wkly Rep. 2022;71(16):574-581. Available at: https://www.ncbi.nlm.nih.gov/pubmed/35446827.
  15. Siegel DA, Reses HE, Cool AJ, et al. Trends in COVID-19 cases, emergency department visits, and hospital admissions among children and adolescents aged 0–17 years—United States, August 2020–August 2021. MMWR Morb Mortal Wkly Rep. 2021;70(36):1249-1254. Available at: https://www.ncbi.nlm.nih.gov/pubmed/34499628.
  16. 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 Mortal Wkly Rep. 2022;71(7):271-278. Available at: https://www.ncbi.nlm.nih.gov/pubmed/35176003.