Pediatric COVID-19 incidence parallels trends in adults

The weekly percentages of positive COVID-19 tests among children and adolescents paralleled trends in adults, including during months when schools were open for in-person learning, data published in MMWR showed.

Researchers also reported that the incidence of COVID-19 was lower among younger children, “suggest[ing] that the risk for COVID-19 introduction and transmission among children associated with reopening child care centers and elementary schools might be lower than that for reopening high schools and institutions of higher education.”

Eva Leidman, MSPH, an epidemiologist with the CDC’s Emergency Response and Recovery Branch, and colleagues assessed SARS-CoV-2 RT-PCR tests results from May 31 through Dec. 12 and stratified the results in five age groups — 0 to 4 years; 5 to 10 years, 11 to 13 years, 14 to 17 years and 18 to 24 years.

From March 1 through Dec. 12, the authors reported there were more than 2.87 million laboratory-confirmed pediatric COVID-19 cases in 44 states, the District of Columbia, two territories and one freely associated state.

The majority of these cases occurred in the oldest group (57.4%), followed by those aged 14 to 17 years (16.3%), those aged 5 to 10 years (10.9%), those aged 11 to 13 years (7.9%) and those aged 0 to 4 years (7.4%). Overall, 51.8% of positive tests occurred in females.

The authors reported that pediatric cases declined between July and September, and then began increasing through December, similar to adults. The highest weekly incidence in all age groups was in the final week of the study period, the week of Dec. 6 — 99.9 cases per 100,000 in those aged 0 to 4 years, 131.4 per 100,000 in those aged 5 to 10 years, 180.6 per 100,000 in those aged 11 to 13 years, 255.6 per 100,000 in those aged 14 to17 years and 379.3 per 100,000 in those aged 18 to 24 years, Leidman and colleagues reported.

Among all youth, 2.5% were hospitalized, 0.8% were admitted to the ICU and 654 (less than 0.1%) died. Comparably, 16.6% of adults were hospitalized, 8.6% were admitted to the ICU and 5% died. Among pediatric cases, the largest percentage of hospitalizations (4.6%) and ICU admissions (1.8%) occured in those aged 0 to 4 years.

The authors said “for schools to operate safely to accommodate in-person learning, communities should fully implement and strictly adhere to multiple mitigation strategies, especially universal and proper masking, to reduce COVID-19 incidence within the community as well as within schools to protect students, teachers, and staff members.”

“CDC recommends that K–12 schools be the last settings to close after all other mitigation measures have been employed and the first to reopen when they can do so safely,” Leidman and colleagues wrote. “CDC offers tools to help child care programs, schools, colleges and universities, parents, and caregivers plan, prepare, and respond to COVID-19, thereby helping to protect students, teachers, and staff members and slowing community spread of COVID-19.”