PECARN Pie: Pediatric COVID Outcomes - A Global Study from PERN

Severe COVID-19 outcomes in children are uncommon, but the risk is not evenly distributed across pediatric ED patients. Global PERN data help separate well-appearing children likely to do well from those whose age, comorbid disease, or presentation should raise concern.

Pediatric COVID Risk Stratification

• Overall severe outcome rate: Most SARS-CoV-2 positive children evaluated in the ED had a favorable course, with severe outcomes remaining uncommon even across a large international cohort.
• High-risk comorbid conditions: Chronic underlying illness meaningfully shifted risk, with medical complexity emerging as a stronger warning sign than the positive test alone.
• Age-related risk gradient: Risk was not uniform across childhood; infants and adolescents separated from the lowest-risk middle groups in ways that matter at the bedside.
• Presenting illness severity: Abnormal vital signs and concerning respiratory presentation carried more signal than many isolated symptoms. We get into which bedside features changed practice in the episode.
• Disposition implications: The key clinical task is deciding who needs closer observation versus safe discharge, and this dataset offers practical reassurance along with a few important exceptions.

References:

1. PERN-Global.com – Pediatric Emergency Research Network. pern-global.com/. Accessed 10 Feb. 2022.
2. Funk AL, Florin TA, Kuppermann N, et al. Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments: The Global PERN–COVID-19 Study. JAMA Netw Open. 2022;5(1):e2142322. PMID 35015063