LAUSR

INTRODUCTION Though severe illness due to COVID-19 is uncommon in children, there is an urgent need to better determine the risk factors for disease severity in youth. This study aims to determine the impact a preexisting endocrine diagnosis has on severity of COVID-19 presentation in youth. METHODS Cross-sectional chart review study included all patients less than 25 years old with a positive SARS-CoV-2 PCR at St. Louis Children's Hospital between March 2020 and February 2021. Electronic medical record data for analysis included: patient demographics, BMI percentile, inpatient hospitalization or admission to the pediatric intensive care unit, presence of a preexisting endocrine diagnosis such as: diabetes mellitus (Type 1 and Type 2), adrenal insufficiency, and hypothyroidism. Two outcome measures were analyzed in multivariate analysis: inpatient admission and PICU admission. Adjusted Odds ratios with 95% CI were calculated using binary logistic regression, along with p values after Wald Chi-Square analysis. RESULTS 390 patients were included in the study. Mean age 123.1 (+ 82.2) months old. 50.3% of patients were hospitalized, and 12.1% of patients were admitted to intensive care. Preexisting diagnosis of diabetes mellitus, obesity, and hypothyroidism were associated with an increased risk of hospital and ICU admission, independent of socioeconomic status. DISCUSSION/CONCLUSION This study provides evidence that unvaccinated youth with a preexisting diagnosis of obesity, hypothyroidism, or diabetes mellitus infected with COVID-19 are more likely to have a more severe clinical presentation requiring inpatient hospital admission and/or intensive care.