The risk of severe illness and death to children from Covid-19 is vanishingly small, according to the biggest study yet of those admitted to hospital, which the researchers say should reassure parents as they return to school.

The study included two-thirds of all patients admitted to hospitals across England, Scotland and Wales with Covid-19. Of these, 651 – less than 1% – were children and young people under 19. Six of these patients – less than 1% – died. All had severe underlying health conditions.

“They were children with profound co-morbidities – not a touch of asthma and not cystic fibrosis,” said Calum Semple, professor in child health and outbreak medicine at the University of Liverpool, and co-lead of the study by the International Severe Acute Respiratory and emerging Infection Consortium. Their conditions included cancer and serious neurological, blood or heart issues.

Co-author of the paper published in the BMJ, Dr Olivia Swann, clinical lecturer in paediatric infectious diseases at the University of Edinburgh, said: “The absolute risk of being admitted to hospital is tiny.” The risk of severe disease and death was also very small.

But among those children who were admitted to critical care, they found those under the age of one were at three times the usual risk, although that included premature babies born and diagnosed in the hospital.

Also at two to three times higher risk of ending up in critical care were black children. “The issues around ethnicity are very complicated,” said Semple. “They are issues which can partly be explained by deprivation. Some are explained by exposure in the community.”

There were also underlying conditions, such as high blood pressure, which are more prevalent in black people, he said. But black children who were completely healthywere at no extra risk, said Semple. The message to the mother of a black child in Brixton or Glasgow was “they are safe to go back to school”, he said.

Children with obesity were at higher risk. So were children in the 10-14 age bracket, who were the ones more likely to suffer from multisystem inflammatory syndrome, a new condition thought to be linked to Covid-19.

The researchers said they have identified symptoms that should help doctors diagnose the syndrome and they hope will lead to an expansion of the World Health Organization definition of it. These were a rash, conjunctivitis, abdominal pain, vomiting, and a low blood platelet count. “The skin, gut and whole child’s body is quite inflamed,” said Swann.

Semple said parents should be reassured that their children would not be at harm from returning to school. He and Swann were both sending children back in September. Among children, “severe disease and death is vanishingly rare”, he said.

The Guardian

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