Risk to children is ‘vanishingly small’
by Ross Clark
It has been clear from the beginning of the Covid-19 crisis – from the experience in Wuhan, before cases had been confirmed in Britain – that it was a disease with relatively little impact on children. A study led by Liverpool University and published in the British Medical Journal today confirms that and sheds more light on how Covid-19 affects children. The study looks at data from 260 hospitals in England, Scotland and Wales, to which 69,516 patients were admitted with Covid-19 symptoms between 17 January and 3 July. Of these, 651 were aged under 19 and 225 were aged under 12 months. Serious underlying medical conditions were present in 42 per cent of the children.
Most were successfully treated on hospital wards but 116 went on to be admitted to critical care and 58 ended up on mechanical ventilation. In 52 cases, the patients were judged to be suffering from Multi-System Inflammatory Syndrome associated with Covid-19 (MIS-C) – the condition similar to Kawasaki disease and toxic shock syndrome that was identified in London hospitals in March. Six children went on to die. Three were aged under 28 days, had been born very prematurely and had complex congenital anomalies and bacterial sepsis. The other three who died were in the 15 to 18 age bracket. Two had profound neurodisabilities which had compromised their respiratory systems. The other had a suppressed immune system as a result of cancer treatment and was also suffering from bacterial sepsis. No children without serious comorbidities died, and nor did any child between the ages of 28 days and 15 years. However, the 10 to 14 age group was over-represented among those admitted to critical care.
As in the adult population, males were more at risk of being hospitalised than females: boys made up 56 per cent of those admitted. Ethnic minorities, too, were over-represented, with 12 of those hospitalised of South Asian heritage while 10 per cent were black. By comparison, black children account for 4.7 per cent of the child population in England and Wales and 1 per cent in Scotland. The symptoms suffered by the children who were hospitalised varied a little from the symptoms reported in adults. Only 39 per cent had a cough. Fever was present in 70 per cent of cases, nausea/vomiting in 32 per cent and shortness of breath in 30 per cent. Those who went on to be admitted to critical care were especially likely to present with three symptoms: diarrhoea, conjunctivitis and altered consciousness/confusion.
Those who required critical care were likely to have been in hospital several days before they showed symptoms – suggesting that in their case, Covid-19 might have been a hospital-acquired infection. The study is bound to be of interest to those on both sides of the debate about whether schools should return full-time next week. The study shows that children are not immune from Covid-19, but, in the words of one of the authors, the risk of serious illness is extremely low and death ‘vanishingly small’.