COVID-19 in Children During the First Wave of the Pandemic in England

Dawn O'Shea

August 14, 2020

Despite large numbers tested, children accounted for just 1 per cent of COVID-19-positive cases in England during the first wave of the pandemic, states a study published in Archives of Disease in Childhood.

The findings provide more evidence to support the theory that children, unlike adults, are not a major source of COVID-19 infection.

The study included NHS and Public Health England test results plus those carried out by 300 general practices contributing to the Royal College of General Practitioners’ monitoring system for flu-like illness.

Between 16 January 2020 and 3 May 2020, a total of 540,305 people, including 35,200 children under the age of 16 years, were tested for SARS-CoV-2. Around one in four (24%) of all those tested (129,704 out of 540,305) had the virus. Children accounted for 1408 of those 129,704 positive results, equal to 1 per cent of the total and 4 per cent of the 35,200 tests carried out on children. This compares with a rate of 19-35 per cent of adults.

On average, children were nearly six years old when they tested positive for the virus. Just over half (53%) of the cases were among boys. The highest number of tests and positive results were among infants, particularly those under three months, and among one-year-olds.

In general practice, SARS-CoV-2 positivity was low, even in children with acute respiratory infections.

In all, 2961 people with respiratory illnesses were tested for SARS-CoV-2 and 2.8 per cent were positive, compared with 9 per cent of 15-44-year-olds, 18.5 per cent of 45-64-year-olds, 20.5 per cent of 65-79-year-olds and 45.5 per cent of those aged 80 years and above.

The total number of deaths among children between January 2020 and May 2020 in England was not higher than expected compared with the same time period in the previous four years.

Eight of the 1408 children who tested positive for SARS-CoV-2 died. Four died due to COVID-19. They were aged between 10 and 15 years, and three had several co-existing conditions. The case fatality rate for children with COVID-19 in England was estimated to be less than one in 200 (0.5%).

Commenting on the findings, lead author Dr Shamez Ladhani said: “Whilst these numbers are reassuring for children, they include a long period of complete lock down where children were less likely to have been exposed to the virus.”

“We need to remain vigilant as the lock down eases and children have increased contact with other children and adults in the coming weeks. In particular, we need more information about asymptomatic infections and silent transmission,” he said.

Ladhani SN, AminChowdhury Z, Davies HG, Aiano F, Hayden I, Lacy J, Sinnathamby M, de Lusignan S, Demirjian A, Whittaker H, Andrews N, Zambon M, Hopkins S, Ramsay ME. COVID-19 in children: analysis of the first pandemic peak in England. Arch Dis Child. 2020 Aug 12 [Epub ahead of print]. doi: 10.1136/archdischild-2020-320042 View full text.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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