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1668 Child mortality in the pandemic
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  1. Sylvia Stoianova,
  2. NCMD Programme Team NCMD Programme Team
  1. University of Bristol

Abstract

Background This presentation draws on the findings of a national population-based study which collates real-time data on the deaths of children aged 0–17 years in England. More specifically, all child deaths are entered onto a national database within 48 hours of occurring. Additional detailed information on the circumstances of the children’s lives and deaths is subsequently added to support learning that could reduce the number of deaths in future. As the first database of this kind and by linking with national virology results, it was uniquely placed to investigate the effects of SARS-CoV-2, and the national lockdown used to control the virus, on child mortality.

Objectives There is an urgent need to understand the nature and effect of SARS-CoV-2 and measures to control it on illness and mortality in children. This work aims to investigate and quantify the characteristics of children dying with COVID-19 and to investigate patterns of causes or rate of childhood mortality during the pandemic lockdown periods.

Methods We compared the characteristics of the children who died in 2020, split by SARS-CoV-2 status. A negative binomial regression model was used to compare mortality rates in lockdown (23 March-28 June), with children who died in the preceding period (6 January-22 March), as well with those who died during a comparable period in 2019.

Results There is no evidence of excess mortality among children during the period of lockdown; nor substantial changes in any other causes of death during the same period. Children who died and had a positive result for SARS-CoV-2 were more commonly older, and from ethnic minority groups. However, the age and ethnic profile of all-cause child mortality during lockdown appeared similar to deaths pre-lockdown and in 2019. We also found little evidence of over-representation of children with underlying health conditions among children who died with the virus. More specifically, we noted:

  • 1550 child deaths were notified between 23 March and 28 June 2020; 437 of which were linked to SARS-CoV-2 virology records

25 (5.7%) had a positive Polymerase Chain Reaction (PCR) result. PCR positive children were less likely to be white (37.5% vs 69.4%) and were older (12.2 vs 0.7 years) compared to child deaths without evidence of the virus.

Conclusions For the period studied, it is reassuring to note that there is no evidence of excess mortality of children from SARS-CoV-2. Furthermore, the apparent higher frequency of SARS-CoV-2 positive tests among children from Black, Asian and minority ethnic groups is consistent with findings in adults. However, ongoing surveillance is essential as the pandemic continues.

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