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?:abstract
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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 SAR-CoV-2 positive cases between 16January 2020 and 3 May 2020. Intotal, 540 305 people were tested forSARS-COV-2 and 129,704(24.0%) were positive. In children aged <16 years, 35,200 tests wereperformed and 1408 (4.0%) were positive forSARS-CoV-2, 19.1%–34.9% adults.Childhood cases increased from mid-March and peaked on 11 April beforedeclining. Among 2,961individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%–45.5% in adults. Eightchildren died and four (case-fatality rate, 0.3%;95% CI0.07% 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.
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