More Than Half of Children Hospitalized for COVID-19 are Hispanic

Hospitalizations of children for COVID-19 thankfully remain low, but new data shows Hispanic children in North Texas are disproportionately affected. As of Oct. 31, 53% of hospitalized COVID-19 patients at Cook Children’s were Hispanic, while 27% were Caucasian (non-Hispanic) and 15% were Black. The rates reflect a trend seen in children and adults across the country.

“Similar to what has happened with adults, Hispanic children have been most affected during the COVID-19 pandemic,” said Ana Maria Rios, M.D., infectious diseases pediatrician at Cook Children’s. “Hispanic people have the highest burden of all the races and ethnicities in the U.S. and they have the highest risk of contracting infection, and becoming severely ill.”

The Centers for Disease Control and Prevention (CDC) reports similar statistics nationwide. According to a report released in August, Hispanic children are eight times as likely to be hospitalized for COVID-19 as white children. For Black children, the risk is five times as high.

In Tarrant County, overall infection rates for COVID-19 have hit the Hispanic community hardest. This group accounts for 27% of all positive tests, which is the largest percentage across all races and ethnicities.

Why are Hispanic families being hit the hardest?

Out of the 181 children hospitalized with COVID-19 at Cook Children’s between March and October, 96 were Hispanic. But how can this be when white (non-Hispanic) people make up the majority of Tarrant County and surrounding areas?

One reason many experts point to is large numbers of Hispanic workers who are on the frontlines and considered essential.

“A lot of people don’t have the luxury of being able to work from home,” said Vida Amin, M.D., medical director of Cook Children’s Neighborhood Clinics. “It’s kind of the worst recipe. You have adults who have to keep working to put food on the table. You have kids who have to go to daycare or school. All of these factors go into play.”

She says another risk is that Hispanic families are more likely to have multiple generations living under one roof.

“We saw this in Italy early in the pandemic. I remember I was curious about why is this happening in Italy and I started to look at the literature. I saw many younger people, in their twenties and teens, were working in the city and they'd come back home where they were living with their grandparents,” said Dr. Amin. “I think it’s a very similar situation here.”

Bianka Soria-Olmos, D.O., a pediatrician at Cook Children’s office in Haslet, has been an outspoken advocate in the Hispanic community throughout the pandemic. After speaking on various Facebook Live events and news interviews targeted toward Spanish-speaking audiences, Dr. Soria-Olmos says getting information out has been critical.

“I think for some people, unless they've known someone who has been personally affected, they may not realize how dangerous and unpredictable the virus is, including the wide range of presentations it can cause from mild symptoms of a cold to life threatening illness that requires intensive care and in some cases even death,” said Dr. Soria-Olmos. “I also feel like the great things about our culture, like the importance of family and celebrations and the act of gathering, have been an Achilles heel for us.”

She says the most important thing for everyone to remember, not just Hispanics, is to be mindful of activities she calls ‘extracurricular.’

“It’s choosing not to do those things where you could potentially become exposed,” said Dr. Soria-Olmos. “The bottom line is leaving your house is a risk when you have transmission rates this high in the community.”

Tarrant County is currently averaging more than 1,000 cases of COVID-19 a day.

Why do Hispanic children end up getting sicker?

It’s important to remember that most children who contract COVID-19 have mild symptoms or are asymptomatic. In fact, overall hospitalizations among children remain low. However, Hispanic children are at the greatest risk of becoming severely ill and needing hospitalization. Experts believe higher rates of underlying health conditions in this population may play a pivotal role.

According to the CDC, obesity, chronic lung disease and prematurity are the most prevalent underlying conditions for children hospitalized with COVID-19. They report nearly 46% of Hispanic children have one or more of these conditions.

“I have to be honest with you that even though I am Hispanic, I didn't realize how much inequities we have in the medical system,” said Dr. Rios. “I think this pandemic is making everyone aware of the public health crisis we’re in. The silver lining is that public health has to be reinvented and we need to work harder in prevention.”

Another issue that can lead to children of any race or ethnicity becoming sicker is delaying medical care.

“I think it's really important that we ask families and schools to remain vigilant about any kind of severe symptoms that they may be noticing in children,” said Dr. Amin. “Don’t just ignore it because children are supposed to be safe from the virus. Some kids do get very sick and we need to be taking these cases seriously and seeking out medical care.”

Symptoms of COVID-19 in children include:

• Fever or chills
• Cough
• Nasal congestion or runny nose
• New loss of taste or smell
• Sore throat
• Shortness of breath or difficulty breathing
• Diarrhea
• Nausea or vomiting
• Stomachache
• Tiredness
• Headache
• Muscle or body aches
• Poor appetite or poor feeding, especially in babies under 1 year old

Dr. Amin adds, “As a clinician, I hope my families will recognize if their child is in a high-risk category, and that they take it seriously when their child becomes ill and seek out care early.”

What can families do to protect their children?

First and foremost, take COVID-19 safety precautions as seriously. This means wearing a mask in public, washing your hands frequently and using hand sanitizer when handwashing is not possible.

“Wash your hands every chance you get and wear a mask,” said Dr. Rios. “We now know masks work both ways. At first, we thought they would only protect others, but we now know masks make a big difference in the amount of virus that can get to us and make us sick.”

It’s also critically important to stay home from work and school when sick. If your child is exhibiting any symptoms of COVID-19, make an appointment with your pediatrician or a Cook Children’s Urgent Care. These visits can be in person or virtual from your phone or computer using a MyCookChildren’s account, which you can easily sign up for here.

“Not everyone is aware that we offer virtual appointments at our urgent care clinics and at our community based (Neighborhood) clinics,” said Dr. Amin. “For families who are working and juggling other things, signing up for MyCookChildren’s is a great way to schedule appointments and to make sure they can see a doctor quickly.”

Dr. Amin also urges parents not to skip well-visits and vaccines.

“These appointments are our chance to discuss their child’s health, prevent serious illnesses through vaccines and help them understand what to do in case their child becomes sick,” she says. “If anyone out there is wondering if they should get their child’s flu shot this year, they should know the influenza vaccine is recommended for all children over 6 months of age, with rare exception. Please discuss it with your primary care physician. As for our clinics, we have safety protocols in place to allow families to wait in their cars until they’re called in and have taken many other safety precautions as well.”

Another thing families can do to protect themselves and their children is to limit gatherings with people outside of their household, which can be increasingly difficult with the holidays in full swing.

“We realize how hard it is to say ‘We’re not going to get together this year,’” said Dr. Soria Olmos. “But we have to do our part to get the community numbers down. To do that, we need to keep our holiday celebrations to our households, and we hope that we will not have to do this ever again.”