Odd David, Stoianova Sylvia, Williams Tom, Thursby-Pelham Anna, Ladhani Shamez N, Oligbu Godwin, Fleming Peter, Luyt Karen
Cardiff University, Cardiff, UK.
University of Bristol, Bristol, UK.
BMJ Open. 2025 Feb 5;15(2):e092627. doi: 10.1136/bmjopen-2024-092627.
The aim of this analysis was to describe the epidemiology, demographics and characteristics of children and young people (CYP) who died of SARS-CoV-2 infection in England during the first 2 years of the pandemic.
The cohort investigated in this study is all CYP, born alive at, or after, 22 weeks of gestation, who died before their 18th birthday between 1 February 2020 and 31 March 2022 in England. All cases were reviewed to identify if SARS-CoV-2 probably, or possibly, contributed to death. Mortality rates were calculated, assuming a Poisson distribution, for the whole population, and split by demographics and patient characteristics.
England.
6389 CYP deaths in England reported to the National Child Mortality Database (NCMD).
Risk of death.
88 of the 6389 deaths of CYP were identified as deaths probably due to COVID-19. Thus, COVID-19 was responsible for 1.4% of all deaths of CYP in this 26-month period. Overall mortality rate due to COVID-19 in CYP was 3.59 (2.88-4.42) per 1 000 000 person years, being highest in the youngest (< 5 years; 4.68 (3.16-6.68)) and oldest (16/17 years; 4.83 (2.57-8.26)) CYP. Asian and Black CYP had higher mortality than those from white backgrounds (p<0.001), and mortality rate increased with increasing deprivation. The majority (61/77, 79.2) of CYP who died of COVID had a documented life limiting condition.
Mortality rates were highest in less than 5 years old. Despite social changes, and shielding of vulnerable CYP, children with life-limiting (but not necessarily life-threatening) conditions, appeared to have the highest mortality rates, similar to that seen in adults with comparable underlying conditions. The risk of death in more deprived neighbourhoods and in those from Asian and Black ethnic backgrounds was increased, and this was not explained by their other demographic characteristics.
本分析旨在描述在疫情的头两年里，英格兰死于新冠病毒感染的儿童和青少年（CYP）的流行病学、人口统计学及特征。
本研究调查的队列是所有在妊娠22周及以后出生、于2020年2月1日至2022年3月31日期间在英格兰未满18岁死亡的CYP。对所有病例进行审查，以确定新冠病毒是否可能或有可能导致死亡。假定为泊松分布，计算了整个人口的死亡率，并按人口统计学和患者特征进行划分。
英格兰。
向国家儿童死亡数据库（NCMD）报告的英格兰6389例CYP死亡病例。
死亡风险。
在6389例CYP死亡病例中，有88例被确定为可能死于新冠病毒。因此，在这26个月期间，新冠病毒导致了CYP所有死亡病例的1.4%。CYP中因新冠病毒导致的总体死亡率为每100万人年3.59（2.88 - 4.42），在最年幼（<5岁；4.68（3.16 - 6.68））和最年长（16/17岁；4.83（2.57 - 8.26））的CYP中最高。亚裔和黑人CYP的死亡率高于白人背景的CYP（p<0.001），且死亡率随贫困程度增加而上升。死于新冠病毒的CYP中，大多数（61/77，79.2%）有记录在案的危及生命的疾病。
5岁以下儿童死亡率最高。尽管社会发生了变化，且对脆弱的CYP进行了防护，但患有危及生命（但不一定危及生命）疾病的儿童似乎死亡率最高，这与患有类似基础疾病的成年人情况相似。在更贫困社区以及亚裔和黑人种族背景的人群中，死亡风险增加，且这无法通过他们的其他人口统计学特征来解释。
