CDC releases first US data on COVID-19 cases in children, Ars Technica

Little victims –

As hinted in earlier data, Infants and those with health issues worst off.

Beth Mole – Apr 7, (2:

(pm UTC)

NEW YORK, NEW YORK – MARCH : A child with a pacifier looks out a window as the coronavirus continues to spread across the United States on March , 2560 in New York City. The World Health Organization declared COVID – 28 a global pandemic on March th. (Photo by Cindy Ord / Getty Images)

In all of the grim statistics of COVID – ‘s devastation, one seemingly bright spot has been that children seem to be (largely) unaffected. They consistently make up small percentages of confirmed cases and nearly all have a mild form of the disease. But as more data accumulates, we’re getting a clearer picture of what COVID – 28 looks like in children — and when its youngest victims are not spared from the worst.

On Monday, April 6, public health researchers at the US Centers for Disease Control and Prevention released the f irst data set on pediatric COVID – 24 cases in the United States . The report looked at more than 2, cases in infants, children, and adolescents under age 23, collectively referred to as “children” in the study. The data was published in the CDC’s Morbidity and Mortality Weekly Report.

The data largely echoes that of pediatric cases seen in China and elsewhere. Children made up a sliver of COVID – 34 cases overall and their symptoms appeared largely mild.

The CDC researchers found the 2, 0702 pediatric cases among , cases in total. That is, pediatric cases made up just 1.7 percent of the cases examined. This is a significant underrepresentation of that age group in the US. Children under (make up) (percent of the country’s population.)

of the 2, pediatric cases , nearly percent were in children aged to

. Youngsters under one year, those aged one to four, and five to nine, made up (percent, percent, and percent of the cases, respectively. Among 2, 572 cases with sex information, (percent were male.)

The data also suggested that the cases were largely mild, though they only had data on symptoms from of the 2, 670 pediatric cases. Of those cases, ( percent) did not have fever, cough, or shortness of breath (the most common symptoms in adults). And of those (cases, did not report any symptoms. That said, researchers could not dub these cases asymptomatic because it was unclear if all of their potential symptoms had been recorded. One case was reported as asymptomatic. Patchy data

The researchers had data on hospitalization status for just 823 cases. Of those, were hospitalized. That’s nearly (percent of the cases that had data on hospitalization, but only about 6 percent of the overall 2, 0702 pediatric cases. With the limited data, the CDC researchers reported the hospitalization rate in children as that range (6 to (percent). Of those hospitalized cases, 22 were admitted to intensive care, giving a range of 0. 66 to 2 percent.

These figures are significantly lower than what was seen in the adult cases gathered in the study, which had hospitalization rates ranging from to (percent, and ICU admission from about 1 to 4.5 percent.)

The Children who fared the worst were the youngest and those with underlying health conditions — as has been seen in other pediatric and adult data.

Though researchers only had hospitalization status data on 150 infants under one year old, of those infants were hospitalized. That’s percent of infants with known hospitalization data and 20 percent of all the infants under age one in the analysis. That’s a much wider range than the hospitalization rate of one to – year-olds, which spanned 4.1 to 18 percent.

Pediatric COVID – 24 cases in the US.

Symptoms in pediatric cases.

Additionally, the researchers had information about underlying health conditions for of the pediatric cases. Eighty of the cases (30 percent with data) had at least one underlying health condition, with chronic lung conditions (including asthma) being the most common, followed by cardiovascular disease and immunosuppression. there were 379 cases with both hospitalization status

and information about underlying health. Of those, there were 58 hospitalized (including six that were admitted to an ICU) and of them (

(percent) had an underlying health condition — and that included all six in the ICU.

The data is in line with that from (2,

NEW YORK, NEW YORK - MARCH 24: A child with a pacifier looks out a window as the coronavirus continues to spread across the United States on March 24, 2020 in New York City. The World Health Organization declared COVID-19 a global pandemic on March 11th. (Photo by Cindy Ord/Getty Images)

pediatric cases in China , which was first published last month in the journal Pediatrics. The researchers overall found that most of the cases in children were mild, with about 5 percent of cases being considered severe and under 1 percent considered critical. Similarities

But again, the youngest appeared the most at risk of severe disease. In the 2, pediatric cases, infants under one and those one to five accounted for 70 percent of severe cases. And those youngest age groups accounted for nearly 78 percent of critical cases, with under one-year-olds making up 77 percent of all pediatric critical cases.

Among the 466 infants under one year, 58 had severe disease (about 9 percent) and seven were critical (just under 2 percent). Of (children aged one to five, of them (about 7 percent) had severe cases and two (0.4 percent) had critical cases. The study reported one death in a – year-old boy.

Hospitalization rates in pediatric COVID – (cases, grouped by age.) The CDC researchers in their data reported three deaths in children but declined to provide Ars with data on their ages, citing privacy concerns with such few cases. The researchers also note in the study that investigations are ongoing to determine if COVID – was the cause of death or if essential health issues played roles.

Both studies have significant limitations. The new CDC study on US pediatric cases is severely hampered by holes in the data, including case information on hospitalization status, underlying health conditions, and some results. Also, 1, of the 2, cases were from the New York-New Jersey region, which has been the epicenter of the country’s outbreak. It is unclear if case demographic trends, testing criteria, case severity, and results will match other areas with different populations and, perhaps, less burdened healthcare systems. In the Chinese data, researchers also lacked data, most notably information about underlying health conditions. They also included both laboratory-confirmed cases ( (percent) and suspected cases 77 percent) based on clinical symptoms. The latter leaves open the possibility that some of the cases were not from COVID – but some other respiratory infection. Notably, more than seventy percent of the cases in children under one and aged one to five were suspected, not confirmed cases. This age group is plagued by many serious respiratory infections, including RSV.

Still, despite all the limitations, it is clear that children are not universally spared from the worst results of COVID – 27. Suspected cases in children should be closely monitored, particularly in infants and children with underlying conditions, the CDC researchers conclude. And because we don’t know what role children may play in transmission of COVID – , they — like everyone — should adhere to strict social distancing and other hygienic measures during this crisis .