COVID-19 trends and severity among symptomatic children aged 0–17 years in 10 European Union countries, 3 August 2020 to 3 October 2021

Abstract

We estimated risks of severe outcomes in 820,404 symptomatic paediatric COVID-19 cases reported by 10 European Union countries between August 2020 and October 2021. Case and hospitalisation rates rose as transmission increased but severe outcomes were rare: 9,611 (1.2%) were hospitalised, 640 (0.08%) required intensive care and 84 (0.01%) died. Despite increased individual risk (adjusted odds ratio hospitalisation: 7.3; 95% confidence interval: 3.3–16.2; intensive care: 8.7; 6.2–12.3) in cases with comorbidities, most (83.7%) hospitalised children had no comorbidity.

COVID-19 in children in NSW, Australia, during the 2021 Delta outbreak: Severity and Disease spectrum

“…30 Our data shows that a history of medical comorbidities is an important risk factor for medical admission to hospital and intensive care, in keeping with previous studies. 3,5,31 We did not identify a high risk of admission in those with a history of immunosuppression (also in keeping with previous studies); 30,32 although an important caveat to this finding is that there were relatively few of these admissions among our cohort of >17,000 children. Due to the large number of children managed by virtual care, another limitation of our study was that we were unable to characterise all the demographic and medical co-morbid and clinical features among cases of all the children under this model of care; but selected a random sample that was likely representative of the larger cohort of children.…”

The Role of Children and Young People in the Transmission of SARS-CoV-2

“…2 The vast majority of severe cases and deaths occur in older adults and high-risk groups with underlying health conditions, while children and young people (CYP) predominantly have a mild disease course, with approximately one-third of cases being asymptomatic. 3 , 4 Data from 10 European Union countries from August 2020 to October 2021, a time when the alpha variant was dominant in most European countries, revealed that in the age group 1–18 years hospitalization was required in <1.2% of all reported cases. Fewer than 0.04% of CYP developed severe disease and the overall case fatality rate was equal to or below 0.01%.…”

“…Fewer than 0.04% of CYP developed severe disease and the overall case fatality rate was equal to or below 0.01%. 3 Conversely, CYP suffered widely from mitigation measures during the pandemic such as social distancing and school or day-care closures.…”

Transmission of SARS-CoV-2 by children: a rapid review, 30 December 2019 to 10 August 2020

“…However, unlike in other viral epidemics, for example influenza [ 47 ], during the early stages of the COVID-19 pandemic, children did not appear to be key transmitters of SARS-CoV-2 with reported transmission from children being low. Studies published subsequent to this review have highlighted that the proportion of paediatric COVID-19 cases has risen as overall transmission has increased [ 5 ]. The majority of included studies have looked at household transmission related to known cases and it was often unclear who the index patient was.…”

“…Understanding the burden and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children is essential for implementing appropriate public health measures and taking decisions about the provision of childcare and education. Adults and children of any age can be infected with SARS-CoV-2, however, paediatric SARS-CoV-2 infection is often milder, most children with symptomatic COVID-19 have a low risk of death or hospitalisation, and a large proportion are likely to be asymptomatic [3][4][5]. Initially, reported cases of COVID-19 in paediatric populations accounted for a small percentage of all diagnosed cases.…”