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Covid-19 infection far less likely to be severe in children, finds large UK study

Children and young people are far less likely to suffer severe Covid-19 than adults, according to a UK analysis of paediatric hospital admission which also found that death is ‘exceptionally rare’.

Data from 260 hospitals across England, Scotland and Wales showed that up to July 651 patients under the age of 19 were admitted with SARS-CoV-2 infection, with a median age of four years old.

Of those 18% (116) children or young people were admitted to critical care and six died, all of whom had a ‘profound comorbidity’, the researchers said in the BMJ.

The ISARIC study through which the data was collected found that those aged under 19 made up just 0.9% of the 69,519 patients enrolled.

In addition, the all cause in-hospital case fatality rate for children and young people was ‘strikingly low’ at 1% (6/627), compared with 27% (18 803/69 516) in the whole cohort, the researchers reported.

But children of black ethnicity were disproportionately severely affected by covid-19 infection, the analysis showed, being more likely to be admitted to critical care.

The team also looked at multisystem inflammatory syndrome (MIS-C) – the WHO definition for the Kawasaki-like disease seen in some children that seemed to be related to high levels of Covid-19 circulating.

They found that 11% of children met the criteria for MIS-C and they tended to be older (average age 10.7 years) and more likely to be of non-white ethnicity. They also tended to be in the areas with the largest Covid-19 outbreaks, mainly London and the Midlands, the BMJ paper reported.

It also appears that children also often suffer a cluster of symptoms including sore throat, nausea, vomiting, abdominal pain, diarrhoea, and rash, the researchers said.

They added that there was a cluster of systemic mucocutaneous- enteric symptoms across the whole cohort and the results suggested the definition for MIS-C may need refining to include low platelet count, fatigue, headache, myalgia, sore throat, and lymphadenopathy.

In July the Government updated its recommendations to remove most children from the shielding list.

Study leader Professor Malcolm Semple, professor in child health and outbreak medicine and consultant respiratory paediatrician at Alder Hey Children’s Hospital, said the strength of the research was that it was prospective and has recruited two-thirds of hospital cases in the UK meaning it was likely to be representative.

‘With this in mind I feel that the findings can be relied upon and used to reassure parents, young people and children about the low risk of Covid-19.’