Associated factors for COVID-19 mortality among children and adolescents in Rio de Janeiro state, 2020-2023.
4 affiliations
- 1Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. [email protected].
- 2Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
- 3Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
- 4Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract
Background
Children 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
A 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
Infants 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
The 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.
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BibTeX
@article{esteves2026associated,
title = {{Associated factors for COVID-19 mortality among children and adolescents in Rio de Janeiro state, 2020-2023.}},
author = {Lívia Esteves and Carlos Eduardo Raymundo and Roberto de Andrade Medronho},
journal = {BMC pediatrics},
year = {2026},
month = jul,
doi = {10.1186/s12887-026-07151-4},
url = {https://europepmc.org/article/MED/42968027},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Associated factors for COVID-19 mortality among children and adolescents in Rio de Janeiro state, 2020-2023.
AU - Lívia Esteves
AU - Carlos Eduardo Raymundo
AU - Roberto de Andrade Medronho
PY - 2026
DA - 2026/07/31
JO - BMC pediatrics
DO - 10.1186/s12887-026-07151-4
UR - https://europepmc.org/article/MED/42968027
AB - Background Children 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 A 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 Infants 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 The 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.
SN - 1471-2431
ER -