Georgia study finds increase in pediatric COVID-19 cases


While everyone is at risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, children are at less risk of serious infection than older adults. But children are not immune to the virus and can be infected through family contact or high community transmission.

Led by Sarita Shah of Emory University, a new study shows weak COVID-19 tests in children, suggesting the results are an underestimate of the true burden of the disease.

“Although children are thought to be less susceptible to COVID-19 than adults, our data on test rates and test positivity indicate that the true burden of COVID-19 in people aged 18 and over less may have been underestimated before the Delta variant, ”the research team concluded.

The study “A Retrospective Cohort Study of COVID-19 Among Children in Fulton County, Georgia, March 2020 – June 2021” was recently published on the medRxiv* preprint server.

How they did

Researchers collected data on confirmed cases of COVID-19 in children aged 0-18 as well as adults 19 and older using the reportable disease electronic surveillance system. The COVID-19 cases in Fulton County were from March 30, 2020 to June 6, 2021. Other information collected for the study included a positive SARS-CoV-2 test sample, age, sex, race , ethnicity, hospitalization, ICU admission, death, symptoms and potential exposure.

Using Georgia’s online analytical statistical information system, the research team collected the number of children and adults living in Fulton County. For the study, children were categorized into different age groups – 0-4, 5-10, 11-13 and 14-18 years old – to make inferences about age differences in COVID infection -19.

What they found

A total of 10,437 pediatric cases of COVID-19 have been reported in Fulton County, Georgia. This translated to approximately 431.4 cases per 10,000 children.

About half of COVID-19 cases were in children aged 14 to 18 (48.3%). The 5-10 age group had the second highest number of cases (21.7%), followed by the 11-13 age group (16.9%) and the 0 age group. at 4 years (13.1%).

Proportion of COVID-19 cases attributed to children aged 0-18 in Fulton County, Georgia by 14-day periods, March 2020 - June 2021

Proportion of COVID-19 cases attributed to children aged 0-18 in Fulton County, Georgia by 14-day periods, March 2020 – June 2021

There was no difference between boys and girls in all age groups. Additionally, non-Hispanic blacks (35%) and non-Hispanic whites (33.5%) were the most common races / ethnicities among pediatric cases.

Children aged 0 to 4 years were the age group most likely to require hospitalization during infection. However, less than 0.5% of COVID-19 cases required intubation.

A child in the 14-18 age group has died.

Common features in pediatric cases of COVID-19

Less than half (43.2%) of children had symptoms of COVID-19 before diagnosis. The most common symptoms at all ages were cough (17.2%) and fever (16.1%).

In older children, about 25.4% of 14-18 year olds reported headaches. However, only 3.8% of children aged 0 to 4 suffered from headaches.

Younger children were more likely to contract SARS-CoV-2 through family contact compared to older children.

All age groups were at similar risk through contact with the community.

Increase in the number of cases of COVID-19 in children

Throughout the study period, the number of pediatric cases reached an unprecedented rate in the Fulton County population.

As of early April 2020, children accounted for 15.4% of all cases in the county. As of September 2020, children accounted for 15.4% of all cases in the county. In April 2021, children accounted for 21.6% of cases.

Fortunately, recent data from early June showed a drop in pediatric cases. At that time, they covered 11.8% of all cases.

Cases of COVID-19 were highest among adults and children aged 14 to 18.

When it comes to COVID-19 test rates, adults were more likely to get tested. Among children, the 14 to 18 age group had the highest screening rates. For example, from December 7 to 20, 2020, children aged 14 to 18 had 2.5 more tests than children aged 0 to 4.

“Despite these marked differences in testing rates, test positivity was similar in all pediatric age groups and the percentage of positivity among pediatric cases was higher than that of adults at almost all time periods observed after July 2020 “, explained the researchers.

*Important Notice

medRxiv publishes preliminary scientific reports which are not peer reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.

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