COVID-19 trends and severity among symptomatic children aged 0–17 years in 10 European Union countries, 3 August 2020 to 3 October 2021

  1. Nick Bundle
  2. Nishi Dave
  3. Anastasia Pharris
  4. Gianfranco Spiteri
  5. Charlotte Deogan
  6. Jonathan E Suk
  7. Study group members

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Abstract

We estimated risks of severe outcomes in 820,404 symptomatic paediatric COVID-19 cases reported by 10 European Union countries between August 2020 and October 2021. Case and hospitalisation rates rose as transmission increased but severe outcomes were rare: 9,611 (1.2%) were hospitalised, 640 (0.08%) required intensive care and 84 (0.01%) died. Despite increased individual risk (adjusted odds ratio hospitalisation: 7.3; 95% confidence interval: 3.3–16.2; intensive care: 8.7; 6.2–12.3) in cases with comorbidities, most (83.7%) hospitalised children had no comorbidity.

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  1. Version published to 10.2807/1560-7917.es.2021.26.50.2101098
  2. ScreenIT

    SciScore for 10.1101/2021.11.25.21266875: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are important limitations to this study. The analysis is based on surveillance data reported to TESSy. Data on vaccination status of the children in this study was not available, however vaccination rates in children were very low generally and vaccines only approved for use in children 12-17 years at the time of the study. As children are less likely to be symptomatic for COVID-19 than adults [11,12], reporting of cases may be biased towards those with severe disease, and although cases with hospitalisation date prior to date of onset were considered not hospitalised for this analysis, some remaining reported paediatric hospitalisations may have been for reasons other than COVID-19. While this could over-estimate the crude risk of hospitalisation, we are aware that hospitalisations are under-reported to TESSy by at least three of the countries in our study, which would have the opposite effect, and our results are comparable to those reported among symptomatic cases in a recent review [10]. Reporting of comorbidities was less likely among cases with severe outcomes, making our effect estimates conservative for cases with a comorbidity. Low numbers of children with severe outcomes diminish the analytical power of the study, particularly for less common outcomes. This, together with incomplete reporting of comorbidities, prevented a detailed risk factor analysis.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.11.25.21266875v1 on medRxiv