COVID-19 Deaths in Children and Young People: Active Prospective National Surveillance, March 2020 to December 2021, England

24 Pages Posted: 20 Jun 2022

See all articles by Marta Bertran

Marta Bertran

Immunisation and Vaccine Preventable Diseases,UK Health Security Agency

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division

Hannah Davies

St George's, University of London

Hester Allen

Public Health England

Tom Clare

Public Health England - National Infection Service

Chloe Davison

UK Health Security Agency - COVID-19 National Epidemiology Cell

Mary Sinnathamby

Government of the United Kingdom - Public Health England

Giulia Seghezzo

UK Health Security Agency

Meaghan Kall

Public Health England Colindale; UK Health Security Agency - COVID-19 National Epidemiology Cell

Hannah Williams

UK Health Security Agency - Emergency Preparedness, Response and Resilience

Nick Gent

UK Health Security Agency

Mary E. Ramsay

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

Shamez Ladhani

Public Health England - Immunisation and Countermeasures Division; University of London, St. George's, Paediatric Infectious Diseases Research Group

Godwin Oligbu

NHS Foundation Trust - London North West Healthcare NHS Trust

Date Written: May 9, 2022

Abstract

Background: COVID-19 deaths are rare in children and young people (CYP). The high rates of asymptomatic and mild infections complicate assessment of cause of death in CYP. We assessed the cause of death in all CYP with a positive SARS-CoV-2 test since the start of the pandemic in England.

Methods: CYP aged <20 years who died within 100 days of laboratory-confirmed SARS-CoV-2 infection between 01 March 2020 and 31 December 2021 in England were followed-up in detail, using national databases, surveillance questionnaires, post-mortem reports and clinician interviews.

Findings: There were 185 deaths during the 22-month follow-up and 81 (43.8%) were due to COVID-19. Compared to non-COVID-19 deaths in CYP with a positive SARS-CoV-2 test, death due to COVID-19 was independently associated with older age (aOR 1.06 95%CI 1.01-1.11, p=0.02) and underlying comorbidities (aOR 2.52 95%CI 1.27-5.01, p=0.008), with a shorter interval between SARS-CoV-2 testing and death. Half the COVID-19 deaths (41/81, 51%) occurred within 7 days of confirmation of SARS-CoV-2 infection and 91% (74/81) within 30 days. Of the COVID-19 deaths, 61 (75.3%) had an underlying condition, especially severe neurodisability (n=27) and immunocompromising conditions (n=12). Over the 22-month surveillance period, SARS-CoV-2 was responsible for 1.2% (81/6,790) of all deaths, with an infection fatality rate of 0.70/100,000 SARS-CoV-2 infections in CYP aged <20 years estimated through real-time, nowcasting modelling and a mortality rate of 0.61/100,000.

Interpretation: COVID-19 deaths remain extremely rare in CYP, with most fatalities occurring within 30 days of infection and in children with specific underlying conditions.

Note:
Funding Information: None.

Conflict of Interests: None.

Ethical Approval: UKHSA has legal permission to process confidential information for national surveillance of communicable diseases without individual patient consent (Regulation 3 of Health Service Regulations 2002) and ethics committee approval is not required.

Keywords: COVID-19, mortality, survival analysis, cause of death

Suggested Citation

Bertran, Marta and Amin-Chowdhury, Zahin and Davies, Hannah and Allen, Hester and Clare, Tom and Davison, Chloe and Sinnathamby, Mary and Seghezzo, Giulia and Kall, Meaghan and Williams, Hannah and Gent, Nick and Ramsay, Mary E. and Ladhani, Shamez and Oligbu, Godwin, COVID-19 Deaths in Children and Young People: Active Prospective National Surveillance, March 2020 to December 2021, England (May 9, 2022). Available at SSRN: https://ssrn.com/abstract=4125501 or http://dx.doi.org/10.2139/ssrn.4125501

Marta Bertran

Immunisation and Vaccine Preventable Diseases,UK Health Security Agency ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Hannah Davies

St George's, University of London ( email )

Cranmer Terrace
London, SW17 0RE
United Kingdom

Hester Allen

Public Health England ( email )

Wellington House,
133-155 Waterloo Rd,
London, SE1 8UG

Tom Clare

Public Health England - National Infection Service ( email )

United Kingdom

Chloe Davison

UK Health Security Agency - COVID-19 National Epidemiology Cell ( email )

London
United Kingdom

Mary Sinnathamby

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

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

Giulia Seghezzo

UK Health Security Agency ( email )

London
United Kingdom

Meaghan Kall

Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

UK Health Security Agency - COVID-19 National Epidemiology Cell ( email )

London
United Kingdom

Hannah Williams

UK Health Security Agency - Emergency Preparedness, Response and Resilience ( email )

United Kingdom

Nick Gent

UK Health Security Agency ( email )

Mary E. Ramsay

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

United Kingdom

Shamez Ladhani (Contact Author)

Public Health England - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

University of London, St. George's, Paediatric Infectious Diseases Research Group

United Kingdom

Godwin Oligbu

NHS Foundation Trust - London North West Healthcare NHS Trust ( email )

Middlesex
United Kingdom

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