COVID-19 Deaths Among Children and Youth Are Extremely Rare: Study

A health worker is taking a swab sample from a child to be tested for COVID-19 in Guangzhou, in China's southern Guangdong Province on July 31, 2022. STR/AFP via Getty Images

COVID-19 deaths among people under 20 are extremely rare, with most fatalities occurring in children with specific underlying conditions, a study found.

The researchers found that deaths in England due to COVID-19 are very low in children and young people (CYP), even with the emergence of new variants. Most deaths occurred in individuals with underlying health conditions, they said.

“Ongoing national surveillance continues to demonstrate a very low risk of death in CYP with confirmed SARS-CoV-2 infection,” they said.

The UK study was published in Plos Medicine on Nov. 8.

Very Low Mortality Rate

The researchers found that COVID-19 was responsible for 1.2 percent of all deaths in CYP “with an Infection Fatality Rate (IFR) of 0.70/100,000 SARS-CoV-2 infections in this age group,” which is 0.0007 percent. The overall mortality rate was found to be 0.61/100,000.

Researchers examined cases of CYP under 20 years of age who died within 100 days of laboratory-confirmed COVID-19 infection.

The follow-up period was between March 1, 2020, and Dec. 31, 2021, covering the peaks of the three pandemic waves including the wild-type, Alpha, and Delta variants.

Out of the 185 deaths in this age group during the 22-month follow-up, 81 cases (43.8 percent) were due to COVID-19.

Seventy-four (91 percent) of the COVID-19 death cases occurred within 30 days of confirmation of infection.

Sixty-one (75.3 percent) had significant underlying health conditions, especially severe neurodisability, and immunocompromising conditions.

The researchers used multiple national databases to identify all CYP who died and detailed follow-up using surveillance questionnaires, post-mortem reports, and clinical interviews.

Mainly With Comorbidities

Non-COVID-19 deaths, 104 cases (56.2 percent) were broken out into unnatural causes, 26 cases (25 percent), and other causes unrelated to COVID-19, 78 cases (75 percent).

Compared to non-COVID-19 deaths in CYP with a positive SARS-CoV-2 test, those who died of COVID-19 were more likely to be older and had underlying comorbidities.

Two-thirds of deaths occurred among 16–19 (39.5 percent) and 12–15 (27.2 percent) year-olds.

The authors said the limitations of this study include the possibility of under-ascertainment of deaths among this age group who were not tested for COVID-19 as well as a lack of direct access to clinical data of hospitalized individuals.

They said that data on fatal COVID-19 in CYP is limited, mainly because these are uncommon outcomes of infection in CYP.

Another study published in October 2022 that examined IFR from studies done across 29 countries found that the median IFR for 0–19 years was 0.0003 percent. That study was done at the Meta-Research Innovation Center at Stanford (METRICS) at Stanford University.

The researchers at METRICS said that at a global level, pre-vaccination IFR may have been as low as 0.03 percent and 0.07 percent for 0–59 and 0–69-year-old people, respectively.