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Assessment of COVID-19 as the underlying cause of death among children and young people aged 0 to 19 years in the US.

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Title: Assessment of COVID-19 as the underlying cause of death among children and young people aged 0 to 19 years in the US.
Authors: Flaxman, S
Whittaker, C
Semenova, E
Rashid, T
Parks, RM
Blenkinsop, A
Unwin, HJT
Mishra, S
Bhatt, S
Gurdasani, D
Ratmann, O
Item Type: Journal Article
Abstract: IMPORTANCE: COVID-19 was the underlying cause of death for more than 940 000 individuals in the US, including at least 1289 children and young people (CYP) aged 0 to 19 years, with at least 821 CYP deaths occurring in the 1-year period from August 1, 2021, to July 31, 2022. Because deaths among US CYP are rare, the mortality burden of COVID-19 in CYP is best understood in the context of all other causes of CYP death. OBJECTIVE: To determine whether COVID-19 is a leading (top 10) cause of death in CYP in the US. DESIGN, SETTING, AND PARTICIPANTS: This national population-level cross-sectional epidemiological analysis for the years 2019 to 2022 used data from the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) database on underlying cause of death in the US to identify the ranking of COVID-19 relative to other causes of death among individuals aged 0 to 19 years. COVID-19 deaths were considered in 12-month periods between April 1, 2020, and August 31, 2022, compared with deaths from leading non-COVID-19 causes in 2019, 2020, and 2021. MAIN OUTCOMES AND MEASURES: Cause of death rankings by total number of deaths, crude rates per 100 000 population, and percentage of all causes of death, using the National Center for Health Statistics 113 Selected Causes of Death, for ages 0 to 19 and by age groupings (<1 year, 1-4 years, 5-9 years, 10-14 years, 15-19 years). RESULTS: There were 821 COVID-19 deaths among individuals aged 0 to 19 years during the study period, resulting in a crude death rate of 1.0 per 100 000 population overall; 4.3 per 100 000 for those younger than 1 year; 0.6 per 100 000 for those aged 1 to 4 years; 0.4 per 100 000 for those aged 5 to 9 years; 0.5 per 100 000 for those aged 10 to 14 years; and 1.8 per 100 000 for those aged 15 to 19 years. COVID-19 mortality in the time period of August 1, 2021, to July 31, 2022, was among the 10 leading causes of death in CYP aged 0 to 19 years in the US, ranking eighth among all causes of deaths, fifth in disease-related causes of deaths (excluding unintentional injuries, assault, and suicide), and first in deaths caused by infectious or respiratory diseases when compared with 2019. COVID-19 deaths constituted 2% of all causes of death in this age group. CONCLUSIONS AND RELEVANCE: The findings of this study suggest that COVID-19 was a leading cause of death in CYP. It caused substantially more deaths in CYP annually than any vaccine-preventable disease historically in the recent period before vaccines became available. Various factors, including underreporting and not accounting for COVID-19's role as a contributing cause of death from other diseases, mean that these estimates may understate the true mortality burden of COVID-19. The findings of this study underscore the public health relevance of COVID-19 to CYP. In the likely future context of sustained SARS-CoV-2 circulation, appropriate pharmaceutical and nonpharmaceutical interventions (eg, vaccines, ventilation, air cleaning) will continue to play an important role in limiting transmission of the virus and mitigating severe disease in CYP.
Issue Date: 3-Jan-2023
Date of Acceptance: 1-Jan-2023
URI: http://hdl.handle.net/10044/1/102011
DOI: 10.1001/jamanetworkopen.2022.53590
ISSN: 2574-3805
Publisher: American Medical Association
Start Page: 1
End Page: 9
Journal / Book Title: Jama Network Open
Volume: 6
Issue: 1
Copyright Statement: © 2023 The Author(s). This is an open access article distributed under the terms of the CC-BY License.
Sponsor/Funder: Medical Research Council (MRC)
Funder's Grant Number: MR/R015600/1
Keywords: Child
Humans
Adolescent
Cause of Death
COVID-19
Cross-Sectional Studies
SARS-CoV-2
Communicable Diseases
Humans
Communicable Diseases
Cause of Death
Cross-Sectional Studies
Adolescent
Child
COVID-19
SARS-CoV-2
Child
Humans
Adolescent
Cause of Death
COVID-19
Cross-Sectional Studies
SARS-CoV-2
Communicable Diseases
Publication Status: Published
Conference Place: United States
Open Access location: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800816
Online Publication Date: 2023-01-30
Appears in Collections:Department of Infectious Diseases
Faculty of Medicine
Imperial College London COVID-19
School of Public Health
Faculty of Natural Sciences
Mathematics
Central Faculty



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