Covid deaths “incredibly rare” among children: shields might do more harm than good

A new series of studies looking at hospital admissions and reported deaths across England suggests that COVID-19 deaths are “incredibly rare” among children, and that the virus carries a lower risk of dying or requiring intensive care among children and young people than was previously understood. 

Nature reports that in a “series of preprints published on medRxiv1-3, a team of researchers picked through all hospital admissions and deaths reported for people younger than 18 in England.”

One paper found that Covid-19 was “very rarely fatal” in under-18 year olds, “even among those with underlying comorbidities.”

The studies found 25 deaths in that age group between March 2020 and February 2021, with half of those deaths in individuals who were living with an underlying complex disability with high health-care needs, such as tube feeding or assistance with breathing.

Rachel Harwood, author of one of the studies and a paediatric surgical registrar at Alder Hey Children’s Hospital in Liverpool, said that, in general, the increased risk of death or requiring intensive care was very small for those under-18. Researchers cautioned that children with some conditions — including obesity and cardiac or neurological conditions — were more at risk, however.

Another study – which is also a preprint still requiring full evaluation – found that the need for intensive care was “incredibly rare” amongst patients aged under-18 according to Joseph Ward of the University College London Great Ormond Street Institute of Child Health.

Researchers examined nationwide health-care data on intensive-care admissions and deaths for that age group in England, and found that of 6,338 hospital admissions for Covid-19, 259 children and young people required treatment in paediatric intensive-care units.

They also found that black children were more likely than whites to require intensive care for the virus, and for paediatric multisystem inflammatory syndrome which is associated with Covid-19 infection.

“Of 3,105 deaths from all causes among the 12 million or so people under 18 in England between March 2020 and February 2021, 25 were attributable to COVID-19 — a rate of about 2 for every million people in this age range. None had asthma or type-1 diabetes, the authors note, and about half had conditions that put them at a higher risk than healthy children of dying from any cause,” Nature reported.

Researchers warned that efforts to shield children from severe complications of COVID-19 might have done more harm than good.

“There’s a general feeling among paediatricians that probably too many children were shielded during the first wave of the pandemic,” Russell Viner, who studies adolescent health at the University College London, said according to Nature.

In some cases, those efforts might have done more harm than good, Elizabeth Whittaker, an infectious-disease specialist at Imperial College London said. “The shields have not been perfect, and have probably caused more stress and anxiety for families than benefit,” she told reporters.

The studies did not look at “long Covid” symptoms, and medics warned results should not be used to conclude that Covid did not matter to children.

 

  • Ward, J. L. et al. Preprint at medRxiv https://doi.org/10.1101/2021.07.01.21259785 (2021).
  • Smith, C. et al. Preprint at medRxiv https://doi.org/10.1101/2021.07.07.21259779 (2021).
  • Harwood, R. et al. Preprint at medRxiv https://doi.org/10.1101/2021.06.30.21259763 (2021).
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