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COVID-19 in children: analysis of the first pandemic peak in England

Shamez N Ladhani1,2, Zahin Amin-Chowdhury3, Hannah G Davies3,2

  • 1Immunisation and Countermeasures Division, Public Health England, London, UK DrShamez@aol.com.

Archives of Disease in Childhood
|August 16, 2020
PubMed

Insights

Children had low rates of COVID-19 infection and mortality during the first pandemic wave. This study found minimal evidence of children

Area of Science:

  • Pediatric infectious diseases
  • Epidemiology
  • Public health

Background:

  • The first wave of the COVID-19 pandemic presented unique challenges for understanding disease dynamics in pediatric populations.
  • Assessing trends in pediatric COVID-19 cases, testing, and outcomes is crucial for public health strategies.
  • Comparing pediatric data with adult data provides essential context for disease impact and management.

Purpose of the Study:

  • To evaluate disease trends, testing practices, community surveillance, case-fatality rates, and excess deaths in children compared to adults during the initial COVID-19 pandemic peak in England.
  • To determine the role of children in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Main Methods:

  • Retrospective analysis of pediatric COVID-19 cases between January and May 2020 in England.
  • Comparison of SARS-CoV-2 positivity rates, acute respiratory infection (ARI) prevalence, case-fatality rates, and excess mortality between children and adults.
  • Inclusion of data from testing practices, community surveillance, and death records.

Main Results:

  • Children constituted 1.1% of all SARS-CoV-2 positive cases, with positivity rates of 4.0% in tested children versus 19.1%-34.9% in adults.
  • Low prevalence of SARS-CoV-2 was observed in children with ARI (2.8%) compared to adults (9.3%-45.5%).
  • The case-fatality rate in children was 0.3%, with no excess childhood mortality detected compared to previous years.

Conclusions:

  • Children represented a small fraction of confirmed COVID-19 cases, even with extensive testing.
  • Low SARS-CoV-2 positivity rates in children, including those with ARI, suggest a limited role in overall infection spread.
  • Findings indicate that children were not significant drivers of SARS-CoV-2 infection and transmission during the first pandemic wave.
Abstract

Keywords:
epidemiologyvirology

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