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Our take —

This report summarizes all publicly available data from state and local health departments on the burden of COVID-19 disease and mortality among children in the US as of July 30, 2020. Despite incomplete reporting, missing data, and divergent methods of reporting among states, it provides an informative description of the extent to which children in the US are diagnosed with, hospitalized, and die from COVID-19. While severe illness due to COVID-19 appears to be relatively rare among children, ongoing monitoring is warranted and the disaggregation of data by age category is important; periodic updates to this summary will be available, providing a useful service for clinicians, the public, and policymakers.

Study design

Case Series, Other

Study population and setting

This non-peer reviewed report provides a summary description of publicly available state-level data on COVID-19 cases, hospitalizations, and deaths among children in the United States. The age range used to define the population of children varied by state/territory; more than half included children aged 0-19 years and additional definitions from most to least commonly used were 0-17, 0-18, 0-14, 0-20, and 0-24 years. Cumulative data obtained from state and local health departments as of July 30, 2020 are presented. All states, except New York and Texas, provided age distributions of COVID-19 cases throughout follow-up, as did New York City, Washington, DC, Puerto Rico, and Guam. Additionally, data on testing, hospitalizations, and death was presented among states providing age distribution for these outcomes.

Summary of Main Findings

As of July 30, 2020, a total of 338,982 cases of COVID-19 were reported among children (8.8% of all documented COVID-19 cases; 447 per 100,000 US children), with 25 states reporting children comprising 10% or more of cases. Between July 16 and July 30, 2020, there was a 40% increase in pediatric cases (going from 241,904 to 338,982), with the majority of new cases occurring in the South and West. Of states reporting (n=8), 3.6-17.8% of children tested were positive. Among states reporting (n=20 and NYC), 0.6-8.9% of all COVID-19 cases among children resulted in hospitalization and 0-0.3% resulted in deaths among states reporting (n=44 and NYC).

Study Strengths

This report uses state- and local-level reports to summarize COVID-19 cases, hospitalizations, and deaths among children in the US.

Limitations

The report includes data that have been reported to local and state health departments, each with inherent limitations and marked differences in the content and format of data across states, yet little detail is given about the methods and limitations. The definition of “child” differed considerably across states, making it difficult to compare metrics between and among states. In addition, the age distribution of cases and hospitalizations was missing for some locations, including New York state (NYC only) and Texas (only reported for 8% of all cases), while Alabama did not disaggregate data below the age of 24 years. The report includes cases, hospitalizations, and death, and therefore does not inform about the rates of SARS-CoV-2 infection among children in the population; further, the proportion of hospitalizations and deaths is reported among cases rather than the population.

Value added

This study is among the first to date to summarize the distribution of COVID-19 cases, testing, hospitalizations, and mortality due to COVID-19 among children in the US using available reports from state and local health departments.

This review was posted on: 20 August 2020