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SARS-CoV-2 tests, confirmed infections and COVID-19-related hospital admissions in children and young people: birth cohort study

Hardelid, P., Favarato, G., Wijlaars, L. , Fenton, L., McMenamin, J., Clemens, T., Dibben, C., Milojevic, A., Macfarlane, A. J. ORCID: 0000-0003-0977-7214, Taylor, J., Cunningham, S.J. & Woods, 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 number e001545. doi: 10.1136/bmjpo-2022-001545

Abstract

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 1 226 855 CYP in the cohort, there were 378 402 tests (a rate of 770.8/1000 CYP-years (95% CI 768.4 to 773.3)), 19 005 PCR-confirmed infections (179.4/1000 CYP-years (176.9 to 182.0)) and 346 admissions (29.4/100 000 CYP-years (26.3 to 32.8)). Infants had the highest COVID-19-related admission rates. The presence of 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-19 vaccine effectiveness among children with chronic conditions and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed.

Publication Type: Article
Additional Information: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.
Publisher Keywords: COVID-19; epidemiology
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
Q Science > QR Microbiology > QR180 Immunology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RJ Pediatrics
Departments: School of Health & Psychological Sciences > Midwifery & Radiography
SWORD Depositor:
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