In the Journals: COVID-19 Deaths among Those < 21 Year Old in the U.S.

On Sept. 15, 2020, the Centers for Disease Control and Prevention (CDC) published data on the incidence of death from COVID-19 in people less 21 year of age (Bixler D, Miller AD, Mattison CP, et al. SARS-CoV-2-Associated Deaths Among Persons <21 Years — United States, February 12-July 31, 2020. Morbidity and Mortality Weekly Report 69: Sept. 15, 2020). At the time of this report, 190,000 deaths from SARS-CoV-2 had been reported in the general population. Although people less than 21 years of age represent 26% of the population, only 121 deaths (0.08% of all COVID-19 deaths) had been reported. In other words, more children died from influenza during the previous epidemic season than from SARS-CoV-2.

Several other observations were of interest:

• First, most of those < 21 years of age who died (70%) were between 10 and 20 years of age. Twenty percent occurred in those 1 to 9 years old, and 10% were in infants less than 1 year of age.
• Second, minority groups were disproportionately represented among the deaths. Among those who died, 45% were Hispanic, 29% were black, and 4% were American Indian or Alaskan Native persons. Although Hispanic, Black and Native populations represent 41% of the U.S. population less than 21 years of age, these groups accounted for 75% of the deaths.
• Third, about 75% of those who died had at least one underlying medical condition; 45% had two or more conditions. Underlying medical conditions included chronic lung disease, most commonly asthma (28%), obesity (27%), neurologic and developmental conditions (22%), and cardiovascular conditions (18%).
• Fourth, while 65% of deaths occurred in the hospital, the remaining deaths for which location was known occurred at home (38%), in the emergency department (55%) or in hospice care (2%).

In summary, SARS-CoV-2-associated deaths in children mimic the racial disparities and medical problems seen in adults.