The coronavirus attacks children with less virulence. The severity and mortality from COVID-19 are much lower among this group. However, a study recently published in the Journal of Public Health Management and Practice suggests that the number of infected children could be much higher than the statistics reflect . According to the research, for every 74 children who enter the intensive care unit because of the new coronavirus, there are another 176 190 who have been infected, that is, for every child admitted to the ICU, there are 2 381 infected with SARS -CoV-2, which for the most part goes unnoticed by health authorities.
The calculations have been carried out by analyzing data from a report prepared by the Chinese Center for Disease Control and Prevention based on a clinical study of more than 2,100 children with the disease in China during the period January-February 2020.
Estimates of the total number of children infected with SARS-CoV-2 in the United States as of April 6, 2020 were calculated using the United States pediatric intensive care unit (PICU) cases and the pediatric criticality ratio. adjusted. The pediatric criticality ratio is the number of seriously ill children with COVID-19 divided by the total number of children infected with SARS-CoV-2 (including asymptomatic).
Projected numbers of critically ill children with COVID-19 were derived by applying adjusted severity and criticality ratios to the United States population data, under various cumulative pediatric infection rate (CPIP) scenarios.
If as of April 6 there were 74 children in US ICUs, an estimated 176,190 children would be infected throughout the country. Of these, 52,381 would be infants and children under 2 years of age, 42,857 children from 2 to 11 years old, and 80,952 children from 12 to 17 years of age. If the CPIP were 5%, there would be 3.7 million infected children, 9,907 would need hospitalization and 1 086 would have to enter the pediatric ICU. In a scenario with a 50% CPIP, 10,865 children would require ICU admission, 99,073 would require hospitalization for severe pneumonia, and 37 million would be infected with SARS-CoV-2.
There are an estimated 74 million children in the United States between the ages of 0 and 17, so projected numbers of severe cases could exceed the resources available for pediatric hospital care in several moderate CPIP scenarios by 2020 And, according to the study, there are only 5,100 pediatric ICU beds in the United States, of which 94% are in the main metropolitan areas. The researchers advise hospitals to plan, according to their circumstances and geographic location, the amount of pediatric equipment and supplies that will be needed, as well as the health professionals that will be needed in the face of an increase in child patients requiring intensive care .
The researchers also refer in their study to the children most vulnerable to the contagion of the new coronavirus, who are those who belong to low-income families and whose parents have to go to work in person and not from home, who live in densely populated areas (homes in close proximity to each other), as well as children with developmental disabilities, those with congenital birth defects, those with underlying medical conditions such as type I diabetes and cancer, and those with pulp disease criticality ratio pediatric experienced in China. This is because we excluded all pediatric Covid-19 cases that were clinically diagnosed but not confirmed by laboratory tests in Dong’s study. To the extent that any of these suspected cases were true cases, the estimates of the criticality ratio used in our study are underestimates ”, can be read in the publication.
chronic diseases such as asthma, which impair lung function.
Study limitations
The researchers claim that the limitations of this study would be lower estimates than could actually be the case .
“It is possible that the conservative criticality ratios we obtained from the Chinese empirical data are an underestimate of the true pediatric criticality ratio experienced in China. This is because we excluded all pediatric Covid-19 cases that were clinically diagnosed but not confirmed by laboratory tests in Dong’s study. To the extent that any of these suspected cases were true cases, the estimates of the criticality ratio used in our study are underestimates ”, can be read in the publication.
Referencia: APA Pathak, Elizabeth Barnett PhD, MSPH; Salemi, Jason L. PhD, MPH; Sobers, Natasha PhD, MBBS, MPH, FRSPH; Menard, Janelle PhD, MPH; Hambleton, Ian R. PhD COVID-19 in Children in the United States, Journal of Public Health Management and Practice: April 16, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/PHH.0000000000001190
