Background: There have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years.
Methods: We used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100,000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors.
Results: Among the 1226855 CYP in the cohort, there were 378,402 tests (a rate of 770.8/1000 CYP years (95% confidence interval [768.4-773.3]), 19,005 PCR confirmed infections (179.4/1000 CYP years [176.9-182.0]) and 346 admissions (29.4/100,000CYP years [26.3-32.8]). Infants had the highest COVID-19-related admission rates. Chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. Overall, 49% of admitted CYP had at least one chronic condition recorded.
Conclusions: Infants, and CYP with chronic conditions are at highest risk of admission with COVID-19. Half of admitted CYP had chronic conditions. Studies examining COVID vaccine effectiveness among children with chronic conditions, and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed.
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Hardelid, P., Favarato, G., Wijlaars, L., Fenton, L., McMenamin, J., Clemens, T., Dibben, C., Milojevic, A., MacFarlane, A., Taylor, Jonathon, Cunningham, S. & Wood, R. 2022, 'SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people: birth cohort study', BMJ Paediatrics Open, 6(1), article no: e001545. https://doi.org/10.1136/bmjpo-2022-001545