COVID-19 in children: analysis of the first pandemic peak in England

Objectives To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England Setting England Participants Children with COVID-19 between January and May 2020 Main outcome measures Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults;community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years Results Children represented 1 1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020 In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24 0%) were positive In children aged <16 years, 35,200 tests were performed and 1408 (4 0%) were positive for SARS-CoV-2, compared to 19 1%–34 9% adults Childhood cases increased from mid-March and peaked on 11 April before declining Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2 8%) were positive compared with 9 3%–45 5% in adults Eight children died and four (case-fatality rate, 0 3%;95% CI 0 07% to 0 7%) were due to COVID-19 We found no evidence of excess mortality in children Conclusions Children accounted for a very small proportion of confirmed cases despite the large numbers of children tested SARS-CoV-2 positivity was low even in children with ARI Our findings provide further evidence against the role of children in infection and transmission of SARS-CoV-2