COVID 19, by the numbers

CDC has released the following national data from February 12 to April 2. In the 149,082 laboratory-confirmed COVID cases for which age was known, 2,572 (1.7%) were among children under 18 years old and fifty-seven percent were males. The pediatric age-group represents 22% of our total population. This would be an over 10-fold decrease in the expected number of pediatric cases. This would mean that either children don’t get infected, or more likely, they are asymptomatic or mildly symptomatic.

This small proportion of pediatric patients gives a preliminary snapshot of the impact on children in the U.S. outbreak. More complete data on hospitalization, symptoms and underlying conditions will be needed to track the impact of COVID-19 on children but the initial data is reassuring. The national data appears to be mirroring the experience at Denver Children’s Hospital, but that information has not been officially analyzed.

The Key Points:

· Among pediatric patients, children under age 1 year and children with underlying health conditions were at highest risk of serious illness resulting in hospitalization. Clinicians are urged to maintain a high index of suspicion for COVID-19 infection and monitor these populations for progression of illness.

· Of 95 children under age 1 hospitalized for COVID-19, five children were admitted to an intensive care unit.

· Three pediatric deaths were reported, but the cases are being reviewed to determine if COVID-19 was the likely cause of death.

· Chronic lung disease (including asthma), cardiovascular disease and immunosuppression were the most common underlying health conditions of 345 children of all ages for which information was available.

· Seventy-three percent of children reported fever, cough or shortness of breath compared to 93% of adult patients.

Social distancing and everyday preventive behaviors (hand hygiene, covering coughs, limiting travel) for all age groups are important and seem to be working. The role of asymptomatic children and those with mild disease in spreading COVID-19 is still under investigation, but better access to testing will help us answer these questions.