COVID-19 in children: Analysis of the first pandemic peak in England

Shamez Ladhani; Zahin Amin-Chowdhury; Hannah G. Davies; Felicity Aiano; Iain Hayden; Joanne Lacy; Mary Sinnathamby; Simon De Lusignan; Alicia Demirjian; Heather Whittaker; Nicholas Andrews; Maria Zambon; Susan Hopkins; Mary Ramsay

doi:10.1136/archdischild-2020-320042

COVID-19 in children: Analysis of the first pandemic peak in England

Shamez Ladhani, Zahin Amin-Chowdhury, Hannah G. Davies, Felicity Aiano, Iain Hayden, Joanne Lacy, Mary Sinnathamby, Simon De Lusignan, Alicia Demirjian, Heather Whittaker, Nicholas Andrews, Maria Zambon, Susan Hopkins, Mary Ramsay

Research output: Contribution to journal › Review article › peer-review

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Abstract

Objectives: To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England. Setting: England.

Participants: Children with COVID-19 between January and May 2020. Main outcome measures: Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years.

Results: Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%-34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%-45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children.

Conclusions: Children accounted for a very small proportion of confirmed cases despite the 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 of SARS-CoV-2.

Original language	English
Article number	320042
Pages (from-to)	1180-1185
Journal	Archives of Disease in Childhood
Volume	105
Early online date	12 Aug 2020
DOIs	https://doi.org/10.1136/archdischild-2020-320042
Publication status	E-pub ahead of print - 12 Aug 2020

Bibliographical note

Funding Information: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Publisher Copyright:© Author(s) (or their employer(s)) 2020. Published by BMJ.

Citation: Ladhani SN, Amin-Chowdhury Z, Davies HG, et al. COVID-19 in children: analysis of the first pandemic peak in England. Archives of Disease in Childhood 2020;105:1180-1185.

DOI: http://dx.doi.org/10.1136/archdischild-2020-320042

Keywords

epidemiology
virology

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Ladhani2020COVID-19InChildrenAnalysisOfThe FirstArchDisChildFinal published version, 803 KBLicence: CC BY-NC

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Ladhani, S., Amin-Chowdhury, Z., Davies, H. G., Aiano, F., Hayden, I., Lacy, J., Sinnathamby, M., De Lusignan, S., Demirjian, A., Whittaker, H., Andrews, N., Zambon, M., Hopkins, S., & Ramsay, M. (2020). COVID-19 in children: Analysis of the first pandemic peak in England. Archives of Disease in Childhood, 105, 1180-1185. [320042]. https://doi.org/10.1136/archdischild-2020-320042

Ladhani, Shamez ; Amin-Chowdhury, Zahin ; Davies, Hannah G. ; Aiano, Felicity ; Hayden, Iain ; Lacy, Joanne ; Sinnathamby, Mary ; De Lusignan, Simon ; Demirjian, Alicia ; Whittaker, Heather ; Andrews, Nicholas ; Zambon, Maria ; Hopkins, Susan ; Ramsay, Mary. / COVID-19 in children : Analysis of the first pandemic peak in England. In: Archives of Disease in Childhood. 2020 ; Vol. 105. pp. 1180-1185.

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title = "COVID-19 in children: Analysis of the first pandemic peak in England",

abstract = "Objectives: To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England. Setting: England. Participants: Children with COVID-19 between January and May 2020. Main outcome measures: Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years. Results: Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%-34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%-45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children. Conclusions: Children accounted for a very small proportion of confirmed cases despite the 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 of SARS-CoV-2.",

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author = "Shamez Ladhani and Zahin Amin-Chowdhury and Davies, {Hannah G.} and Felicity Aiano and Iain Hayden and Joanne Lacy and Mary Sinnathamby and {De Lusignan}, Simon and Alicia Demirjian and Heather Whittaker and Nicholas Andrews and Maria Zambon and Susan Hopkins and Mary Ramsay",

note = "Funding Information: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Publisher Copyright:{\textcopyright} Author(s) (or their employer(s)) 2020. Published by BMJ. Citation: Ladhani SN, Amin-Chowdhury Z, Davies HG, et al. COVID-19 in children: analysis of the first pandemic peak in England. Archives of Disease in Childhood 2020;105:1180-1185. DOI: http://dx.doi.org/10.1136/archdischild-2020-320042 ",

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month = aug,

day = "12",

doi = "10.1136/archdischild-2020-320042",

language = "English",

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Ladhani, S , Amin-Chowdhury, 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, M 2020, 'COVID-19 in children: Analysis of the first pandemic peak in England', Archives of Disease in Childhood, vol. 105, 320042, pp. 1180-1185. https://doi.org/10.1136/archdischild-2020-320042

COVID-19 in children : Analysis of the first pandemic peak in England. / Ladhani, Shamez ; Amin-Chowdhury, Zahin; Davies, Hannah G.; Aiano, Felicity; Hayden, Iain; Lacy, Joanne; Sinnathamby, Mary; De Lusignan, Simon; Demirjian, Alicia; Whittaker, Heather; Andrews, Nicholas ; Zambon, Maria ; Hopkins, Susan ; Ramsay, Mary.

In: Archives of Disease in Childhood, Vol. 105, 320042, 12.08.2020, p. 1180-1185.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - COVID-19 in children

T2 - Analysis of the first pandemic peak in England

AU - Ladhani, Shamez

AU - Amin-Chowdhury, Zahin

AU - Davies, Hannah G.

AU - Aiano, Felicity

AU - Hayden, Iain

AU - Lacy, Joanne

AU - Sinnathamby, Mary

AU - De Lusignan, Simon

AU - Demirjian, Alicia

AU - Whittaker, Heather

AU - Andrews, Nicholas

AU - Zambon, Maria

AU - Hopkins, Susan

AU - Ramsay, Mary

N1 - Funding Information: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Publisher Copyright:© Author(s) (or their employer(s)) 2020. Published by BMJ. Citation: Ladhani SN, Amin-Chowdhury Z, Davies HG, et al. COVID-19 in children: analysis of the first pandemic peak in England. Archives of Disease in Childhood 2020;105:1180-1185. DOI: http://dx.doi.org/10.1136/archdischild-2020-320042

PY - 2020/8/12

Y1 - 2020/8/12

N2 - Objectives: To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England. Setting: England. Participants: Children with COVID-19 between January and May 2020. Main outcome measures: Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years. Results: Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%-34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%-45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children. Conclusions: Children accounted for a very small proportion of confirmed cases despite the 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 of SARS-CoV-2.

AB - Objectives: To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England. Setting: England. Participants: Children with COVID-19 between January and May 2020. Main outcome measures: Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years. Results: Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%-34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%-45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children. Conclusions: Children accounted for a very small proportion of confirmed cases despite the 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 of SARS-CoV-2.

KW - epidemiology

KW - virology

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U2 - 10.1136/archdischild-2020-320042

DO - 10.1136/archdischild-2020-320042

M3 - Review article

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AN - SCOPUS:85090015712

VL - 105

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EP - 1185

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

SN - 0003-9888

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ER -

COVID-19 in children: Analysis of the first pandemic peak in England

Abstract

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