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

<p><strong>OBJECTIVES:</strong> To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England.</p> <p><strong>SETTING:</strong> England.<...

Full description

Bibliographic Details
Main Authors: Ladhani, SN, Amin-Chowdhury, Z, Davies, HG, Aiano, F, Hayden, I, Lacy, J, Sinnathamby, M, de Lusignan, S, Demirjian, A, Whittaker, H, Andrews, N, Zambon, M, Hopkins, S, Ramsay, ME
Format: Journal article
Language:English
Published: BMJ Journals 2020
Description
Summary:<p><strong>OBJECTIVES:</strong> To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England.</p> <p><strong>SETTING:</strong> England.</p> <p><strong>PARTICIPANTS:</strong> Children with COVID-19 between January and May 2020.</p> <p><strong>MAIN OUTCOME MEASURES:</strong> Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years.</p> <p><strong>RESULTS:</strong> Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged &lt;16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%-34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%-45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children.</p> <p><strong>CONCLUSIONS:</strong> Children accounted for a very small proportion of confirmed cases despite the large numbers of children tested. SARS-CoV-2 positivity was low even in children with ARI. Our findings provide further evidence against the role of children in infection and transmission of SARS-CoV-2.</p>