{
  "abstract": "Background\n\nChildren and adolescents with COVID-19 typically present milder symptoms of the infection, with fatal outcomes being rare. This study aimed to analyze the main associated factors for mortality in this population group.Methods\n\nA cross-sectional study was performed to analyze reported COVID-19 cases among individuals under 18 years old in Rio de Janeiro state, Brazil, from March 2021 to September 2023. Pearson's chi-square test was used for categorical variables, and the Wilcoxon test for numerical variables. The significance level was set at 5%. Logistic regression analysis was performed to identify factors associated with COVID-19 mortality in individuals under 18.Results\n\nInfants under 1 year old had a higher mortality chance (OR = 4.70; 95% CI: 2.45-9.60) compared to adolescents aged 15-17 years. Non-white individuals had a lower mortality chance compared to white individuals (OR = 0.64; 95% CI: 0.41-0.99). The presence of fever (OR = 1.83; 95% CI: 1.17-2.89), dyspnea (OR = 11.83; 95% CI: 7.50-18.74), and oxygen saturation below 95% (OR = 11.97; 95% CI: 3.78-33.19) was associated with a higher mortality chance. Patients with heart disease (OR = 7.74; 95% CI: 3.89-14.58) and immunodeficiency/immunosuppression (OR = 17.16; 95% CI: 8.58-32.14) had a higher mortality chance. Infection during the predominance of variants B1_wild (OR = 3.44; CI 1.75-6.81), Gamma (OR = 3.93; CI 2.13-7.44), and Delta (OR = 2.27; CI 1.02-4.84) was associated with a higher mortality chance compared to the Omicron variant.Conclusions\n\nThe main associated factors for death were fever, dyspnea, oxygen saturation below 95% on room air, age under one year, cardiac disease comorbidity, immunodeficiency, and infection during the predominance of B1_wild, Gamma, and Delta variants. Understanding the epidemiological profile and associated factors for mortality in this population is essential to inform effective prevention and control measures and guide optimal clinical management.",
  "abstract_shown": true,
  "affiliations": [
    "Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. liviaesteves@gmail.com.",
    "Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.",
    "Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.",
    "Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lívia Esteves"
    },
    {
      "affs": [
        1
      ],
      "name": "Carlos Eduardo Raymundo"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Roberto de Andrade Medronho",
      "orcid": "0000-0003-4073-3930"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cvafs5r1x6n73.bib",
  "cited_by": 0,
  "doi": "10.1186/s12887-026-07151-4",
  "fulltext_url": "https://europepmc.org/articles/PMC13726005",
  "id": "cvafs5r1x6n73",
  "issns": [
    "1471-2431"
  ],
  "landing_url": "https://europepmc.org/article/MED/42968027",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2725|COVID-19 Clinical Research Studies"
    ]
  ],
  "openalex": "W7171924384",
  "pdf_url": "https://europepmc.org/articles/PMC13726005?pdf=render",
  "pmcid": "PMC13726005",
  "pmid": "42968027",
  "published": "2026-07-31",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/cvafs5r1x6n73.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:54Z",
      "native_id": "MED:42968027",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42968027"
    },
    {
      "first_seen": "2026-11-05T12:22:26Z",
      "native_id": "PMC13726005",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12887-026-07151-4"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|COVID-19 Clinical Research Studies",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Associated factors for COVID-19 mortality among children and adolescents in Rio de Janeiro state, 2020-2023.",
  "title_text": "Associated factors for COVID-19 mortality among children and adolescents in Rio de Janeiro state, 2020-2023.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:03Z",
  "url": "https://research.draconitic.com/paper/cvafs5r1x6n73",
  "venue": "BMC pediatrics",
  "versions": []
}