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COVID-19 in Children: Analysis of the First Pandemic Peak in England

28 Pages Posted: 27 Jul 2020

See all articles by Shamez Ladhani

Shamez Ladhani

Government of the United Kingdom - Immunisation and Countermeasures Division

Zahin Amin-Chowdhury

Immunisation and Countermeasures Division, Public Health England

Hannah G Davies

Immunisation and Countermeasures Division, Public Health England

Felicity Aiano

Immunisation and Countermeasures Division, Public Health England

Iain Hayden

Immunisation and Countermeasures Division, Public Health England

Joanne Lacy

Immunisation and Countermeasures Division, Public Health England

Mary Sinnathamby

Government of the United Kingdom - Public Health England

Simon de Lusignan

University of Oxford - Nuffield Department of Primary Care Health Sciences

Alicia Demirjian

Antimicrobial Resistance and Hospital-acquired Infections Department, Public Health England

Heather Whitaker

Statistics, Modelling, and Economics Department,Public Health England

Nick Andrews

Government of the United Kingdom - Public Health England

Maria Zambon

Public Health England - Virus Reference Department

Susan Hopkins

University of Oxford - NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department

More...

Abstract

Background: Children rarely develop severe or fatal coronavirus disease 2019 (COVID-19) as compared to adults. We assessed disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared to adults during the first pandemic peak in England.

Methods: Public Health England conducts national COVID-19 surveillance using multiple national data sources. Daily positive and negative SARS-CoV-2 results are reported by public health, National Health Service and private laboratories across England. Individuals presenting with acute respiratory infection (ARI) in primary care were swabbed for SARS-CoV-2 as part of community-based surveillance. Daily death registrations were used to estimate childhood deaths compared to the previous five years.

Findings: Between 16 January and 5 May 2020, 129,704 (24.0%) of 540,305 people tested positive for SARS-COV-2; of these, 35,200/536,278 (6.6%) with reported age were in children aged <16 years and 1,408 (4.0%) were positive, compared to 19.1-34.9% in adults. Children represented 1.1% (1,462/129,704) of total cases. COVID-19 cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individual presenting with ARI in primary care, 351 were children and 20 (2.8%) were positive compared to 9.3%- 45.5% in adults. Eight children died and four CFR, 0.3%; 95%CI, 0.07-0.7%) were due to COVID-19. We found no evidence of excess mortality in children.

Interpretation: Children accounted for a very small proportion of confirmed cases despite 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.

Funding Statement: PHE

Declaration of Interests: None.

Ethics Approval Statement: PHE has legal permission, provided by Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002, to process patient confidential information for national surveillance of communicable diseases. This includes PHE’s responsibility to monitor the safety and effectiveness of vaccines, and as such, individual patient consent is not required. PHE’s Caldicott Guardian approved the collection of data by RCGP RSC to support national surveillance.

Keywords: COVID-19; children; epidemiology; case fatality rate; surveillance

Suggested Citation

Ladhani, Shamez and Amin-Chowdhury, Zahin and Davies, Hannah G and Aiano, Felicity and Hayden, Iain and Lacy, Joanne and Sinnathamby, Mary and Lusignan, Simon de and Demirjian, Alicia and Whitaker, Heather and Andrews, Nick and Zambon, Maria and Hopkins, Susan and Ramsay, Mary E., COVID-19 in Children: Analysis of the First Pandemic Peak in England (6/4/2020). Available at SSRN: https://ssrn.com/abstract=3622390 or http://dx.doi.org/10.2139/ssrn.3622390

Shamez Ladhani (Contact Author)

Government of the United Kingdom - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Zahin Amin-Chowdhury

Immunisation and Countermeasures Division, Public Health England

Hannah G Davies

Immunisation and Countermeasures Division, Public Health England

Felicity Aiano

Immunisation and Countermeasures Division, Public Health England

Iain Hayden

Immunisation and Countermeasures Division, Public Health England

Joanne Lacy

Immunisation and Countermeasures Division, Public Health England

Mary Sinnathamby

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Simon de Lusignan

University of Oxford - Nuffield Department of Primary Care Health Sciences

Oxford
United Kingdom

Alicia Demirjian

Antimicrobial Resistance and Hospital-acquired Infections Department, Public Health England

Heather Whitaker

Statistics, Modelling, and Economics Department,Public Health England

Nick Andrews

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Maria Zambon

Public Health England - Virus Reference Department ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Susan Hopkins

University of Oxford - NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance

Oxford
United Kingdom

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department ( email )

United Kingdom

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