During the first year of the pandemic 25 children and teenagers died as a direct result of Covid-19 in England and about 6,000 were admitted to hospital, according to the most complete analysis of national data on the age group to date.
Children seen to be at greatest risk of severe illness and death from the coronavirus were in ethnic minority groups, or had other medical conditions or severe disabilities.
The findings, which have not yet been peer reviewed, will be submitted to the UK’s Joint Committee on Vaccination and Immunisation (JCVI) and the Department of Health and Social Care (DHSC) to help inform policies about who should be offered Covid-19 vaccines or continued to ask to shield.
“This is essentially the first complete national cohort of children and young people affected by Covid-19,” said Prof Russell Viner, en el University College de Londres (UCL) Great Ormond Street Institute of Child Health, who contributed to the research.
Viner added that although children and young people were known to be at low risk of severe illness or death these findings were the first “to really and precisely, in a very large population, give us clear estimates of those risks”..
Using data on hospital admissions covering children in England under a year old up to 17-year-olds, researchers led by Joseph Ward, a doctor at UCL calculated that 5,830 children and young people were admitted to hospital with Covid-19 during the first year of the pandemic, up to the end of February 2021.
Of these children 251 (4%) required intensive care, equivalent to a one in 50,000 chance of being admitted to ICU with Covid-19 for those under 18.
The researchers also identified 690 children and young people who had developed the rare Covid-related condition known as paediatric multisystem inflammatory syndrome (PIMS-TS), of whom 309 required intensive care – equating to a risk of one in 38,911.
Ward said: “Factors linked to a higher risk of severe Covid-19 appear to be broadly consistent for both children and adults. Our study found a higher risk of admission to intensive care among young people of black ethnicity compared to white, as well as among young people with health conditions such as diabetes, asthma and cardiovascular disease. Young people with multiple conditions had the highest risk.”
Por separado, researchers led by Clare Smith at the Bristol Royal Hospital for Children, reviewed all of the child deaths that occurred in England between March 2020 y febrero 2021, to calculate the number that could be directly attributed to Covid-19.
They found that 25 children and young people had died because of the coronavirus, equating to an absolute risk of one in 481,000, or approximately two in a million. Children and young people with complex neurodisability were at the highest risk of death.
Viner said: “These new studies show that the risks of severe illness or death from Sars-CoV-2 are extremely low in children and young people. [They] are important as they will inform shielding guidance for young people as well as decisions about the vaccination of teenagers and children, not just in the UK but internationally.
“My personal view is that it would be very reasonable to vaccinate a number of the groups that we’ve studied who don’t necessarily have a particularly high risk of death but their risk of having severe illness and coming into paediatric intensive care, while still low, is still higher than the general population.
"Sin emabargo, it is about having enough vaccinations and waiting for some of the safety data, which should increase rapidly over the next two to three weeks.”
The studies did not assess the risk of “long Covid” in under 18s. sin embargo, speaking at a separate online seminar organised by the Royal Society of Medicine, one of the country’s leading experts on the condition in children and young people warned that a “tidal wave” of long Covid infections among teens was on the way.
Esther Crawley, a professor of child health at the University of Bristol, said that some frontline doctors were in denial about long Covid in children. “Parents and children are going to their GPs to try to seek help and being turned away.” She also said that her direct experience studying the condition had convinced her that children over the age of 12 should now be vaccinated.
The scale of the problem was also emphasised by Nathalie MacDermott, a doctor and clinical lecturer in paediatrics at King’s College London, who warned of shortages of paediatric resources to cope with it. “We are talking several thousand children, young people and young adults suffering ongoing symptoms. It could be detrimental to their education and, later on, to our economy, not least since we do not have enough paediatricians in this country to manage.”