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COVID-19 deaths in children and young people in England, March 2020 to December 2021: An active prospective national

Marta Bertran1, Zahin Amin-Chowdhury1, Hannah G Davies2

  • 1Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom.

Plos Medicine
|November 8, 2022
PubMed

Insights

Coronavirus Disease 2019 (COVID-19) deaths are rare in children and young people (CYP). Most COVID-19 fatalities in CYP occur within 30 days of infection and are linked to underlying health conditions.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Coronavirus Disease 2019 (COVID-19) deaths are uncommon in children and young people (CYP).
  • Assessing the cause of death in CYP is challenging due to high rates of asymptomatic and mild infections.
  • This study investigated the causes of death in CYP who tested positive for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in England.

Purpose of the Study:

  • To determine the causes of death in children and young people (CYP) who tested positive for SARS-CoV-2.
  • To identify risk factors associated with COVID-19 mortality in CYP.
  • To estimate the overall mortality burden of SARS-CoV-2 in the CYP population.

Main Methods:

  • A detailed follow-up of CYP aged under 20 who died within 100 days of a positive SARS-CoV-2 test in England (March 2020 - December 2021).
  • Data sources included national databases, surveillance questionnaires, post-mortem reports, and clinician interviews.
  • Statistical analysis adjusted for age, sex, ethnicity, and underlying conditions to determine independent associations with COVID-19 mortality.

Main Results:

  • Out of 185 deaths in CYP with SARS-CoV-2 infection, 81 (43.8%) were attributed to COVID-19.
  • COVID-19 deaths were independently associated with older age and underlying comorbidities.
  • Over half of COVID-19 deaths (50.6%) occurred within 7 days of infection confirmation, and 75.3% of these deaths involved children with pre-existing conditions, particularly severe neurodisability or immunocompromise.

Conclusions:

  • COVID-19 mortality remains very rare in children and young people.
  • Fatalities are predominantly observed in CYP with specific underlying health conditions.
  • The majority of COVID-19 deaths in CYP occur relatively soon after infection confirmation.
Abstract

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