Low rates of severe disease, death reported for children with COVID-19

(HealthDay)—Severe disease and death appear to be rare among children and young people hospitalized with laboratory-confirmed COVID-19, according to an observational study in the United Kingdom published online Aug. 27 in The BMJ.

Olivia V. Swann, M.B., Ch.B., from the University of Edinburgh in the United Kingdom, and colleagues conducted a prospective observational cohort study to characterize the clinical features of 651 children (<19 years) admitted to 138 hospitals with laboratory-confirmed severe acute respiratory syndrome coronavirus 2.

The researchers found that patients' median age was 4.6 years and 42 percent had one or more comorbidity. A systemic mucocutaneous-enteric cluster of symptoms was described, including symptoms for the World Health Organization multisystem inflammatory syndrome in children and adolescents temporarily related to COVID-19 (MIS-C). Eighteen percent of children were admitted to critical care, with associations noted for age younger than 1 month, age 10 to 14 years, and Black ethnicity in a multivariable analysis (odds ratios, 3.21, 3.23, and 2.82, respectively). Overall, 1 percent of patients died in the hospital; all had profound comorbidities. Eleven percent of children met the WHO MIS-C criteria; they were older and more likely to be non-White. Children with MIS-C were more likely to be admitted to critical care (73 versus 15 percent). Compared with children without MIS-C, those with MIS-C were also more likely to present with fatigue, headache, myalgia, sore throat, lymphadenopathy, and a low platelet count.

"Our data confirm less severe COVID-19 in children and young people with severe acute respiratory syndrome coronavirus 2 infection than in adults," the authors write. "In agreement with previous reports, we found older age and non-White ethnicity to be associated with MIS-C."

One author disclosed financial ties to Integrum Scientific.

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