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. 2020 Dec;105(12):1180-1185.
doi: 10.1136/archdischild-2020-320042. Epub 2020 Aug 12.

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

Shamez N Ladhani  1   2 , Zahin Amin-Chowdhury  3 , Hannah G Davies  3   2 , Felicity Aiano  3 , Iain Hayden  3 , Joanne Lacy  3 , Mary Sinnathamby  3 , Simon de Lusignan  4   5 , Alicia Demirjian  5   6   7 , Heather Whittaker  8 , Nick Andrews  8 , Maria Zambon  9 , Susan Hopkins  5 , Mary Elizabeth Ramsay  3   10
Affiliations

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

Shamez N Ladhani et al. Arch Dis Child. 2020 Dec.

Abstract

Objectives: 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.

Setting: England.

Participants: Children with COVID-19 between January and May 2020.

Main outcome measures: 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.

Results: 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 <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.

Conclusions: 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.

Keywords: epidemiology; virology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Epidemic curve (A), cumulative number of confirmed cases (B) and proportion of test positives (C) by age group for COVID-19 in children during the first pandemic peak (February to May 2020) in England.
Figure 2
Figure 2
Distribution of confirmed COVID-19 cases in children during the first pandemic peak (February to May 2020) in England.
Figure 3
Figure 3
Age distribution of children with confirmed COVID-19 by sex in children during the first pandemic peak (February to May 2020) in England.
Figure 4
Figure 4
Percentage of test positivity by age group in children (green bar) compared with adults (blue bars) tested for severe acute respiratory syndrome coronavirus 2 during the first pandemic peak (February to May 2020) in England.
Figure 5
Figure 5
Number of children with acute respiratory infection who were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in general practices across England over the course of the pandemic (A) and by age (B). Figure 3C depicts the proportion of individuals with acute respiratory infection who tested positive by age and sex in England.
Figure 6
Figure 6
Observed, delay-corrected and expected all-cause deaths in children aged 0–15 years in England from 2015 (week 40) to 2020 (week 18). Data are shown by week of death.
See this image and copyright information in PMC

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