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. 2021 Nov;148(5):e2021052273.
doi: 10.1542/peds.2021-052273. Epub 2021 Aug 12.

Deaths in Children and Adolescents Associated With COVID-19 and MIS-C in the United States

David W McCormick  1   2 , LaTonia Clay Richardson  3 , Paul R Young  3 , Laura J Viens  3 , Carolyn V Gould  3 , Anne Kimball  3   2 , Talia Pindyck  3 , Hannah G Rosenblum  3   2 , David A Siegel  3 , Quan M Vu  3 , Ken Komatsu  4 , Heather Venkat  4   5 , John J Openshaw  6 , Breanna Kawasaki  7 , Alan J Siniscalchi  8 , Megan Gumke  9 , Andrea Leapley  9 , Melissa Tobin-D'Angelo  10 , Judy Kauerauf  11 , Heather Reid  11 , Kelly White  12 , Farah S Ahmed  13 , Gillian Richardson  14 , Julie Hand  14 , Kim Kirkey  15 , Linnea Larson  16 , Paul Byers  17 , Ali Garcia  18 , Mojisola Ojo  19 , Ariela Zamcheck  20 , Maura K Lash  21 , Ellen H Lee  21 , Kathleen H Reilly  21 , Erica Wilson  22 , Sietske de Fijter  23 , Ozair H Naqvi  24 , Laurel Harduar-Morano  5   25 , Anna-Kathryn Burch  26 , Adele Lewis  27 , Jonathan Kolsin  28 , Stephen J Pont  28 , Bree Barbeau  29 , Danae Bixler  3 , Sarah Reagan-Steiner  3 , Emilia H Koumans; Pediatric Mortality Investigation Team
Affiliations

Deaths in Children and Adolescents Associated With COVID-19 and MIS-C in the United States

David W McCormick et al. Pediatrics. 2021 Nov.

Abstract

Objectives: To describe the demographics, clinical characteristics, and hospital course among persons <21 years of age with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated death.

Methods: We conducted a retrospective case series of suspected SARS-CoV-2-associated deaths in the United States in persons <21 years of age during February 12 to July 31, 2020. All states and territories were invited to participate. We abstracted demographic and clinical data, including laboratory and treatment details, from medical records.

Results: We included 112 SARS-CoV-2-associated deaths from 25 participating jurisdictions. The median age was 17 years (IQR 8.5-19 years). Most decedents were male (71, 63%), 31 (28%) were Black (non-Hispanic) persons, and 52 (46%) were Hispanic persons. Ninety-six decedents (86%) had at least 1 underlying condition; obesity (42%), asthma (29%), and developmental disorders (22%) were most commonly documented. Among 69 hospitalized decedents, common complications included mechanical ventilation (75%) and acute respiratory failure (82%). The sixteen (14%) decedents who met multisystem inflammatory syndrome in children (MIS-C) criteria were similar in age, sex, and race and/or ethnicity to decedents without MIS-C; 11 of 16 (69%) had at least 1 underlying condition.

Conclusions: SARS-CoV-2-associated deaths among persons <21 years of age occurred predominantly among Black (non-Hispanic) and Hispanic persons, male patients, and older adolescents. The most commonly reported underlying conditions were obesity, asthma, and developmental disorders. Decedents with coronavirus disease 2019 were more likely than those with MIS-C to have underlying medical conditions.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Study flow diagram. Abbreviation: MIS-C, Multisystem inflammatory syndrome in children * The interim COVID-19 case definition published by the Council of State and Territorial Epidemiologists on August 5, 2020 was used to classify cases as confirmed or probable. †Cases met MIS-C criteria if they fulfilled the case definition published in the CDC Health Alert Network Health Advisory on May 14, 2020.
Figure 2.
Figure 2.
Histogram showing the age distribution for all decedents (A), those who died in the hospital (B), and those who died at home or in the emergency department (C).
See this image and copyright information in PMC

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