SARS-CoV-2 Infection Rates Generally Low in U.S. Children

TUESDAY, Nov. 24, 2020 -- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates are generally low among children, with variation in testing and positivity by race/ethnicity, according to a study published online Nov. 23 in JAMA Pediatrics.

L. Charles Bailey, M.D., Ph.D., from the Children's Hospital of Philadelphia, and colleagues describe testing for SARS-CoV-2 in a study involving data from 135,794 patients younger than 25 years from seven U.S. pediatric health systems.

The researchers found that 4 percent of those tested were infected with SARS-CoV-2. Patients of Black, Hispanic, and Asian race/ethnicity had lower rates of testing than Whites (odds ratios [ORs], 0.70, 0.65, and 0.60, respectively); however, their likelihood of having a positive result was significantly increased (ORs, 2.66, 3.75, and 2.04, respectively). An increased risk for infection was seen in association with older age (ORs: 5 to 11 years, 12 to 17 years, and 18 to 24 years: 1.25, 1.92, and 3.51, respectively), public payer (OR, 1.43), outpatient testing (OR, 2.13), and emergency department testing (OR, 3.16). Certain diagnosis groups had a higher risk for positive test results, including those with malignant disorders, endocrinologic disorders, and gastrointestinal disorders. Of the children with positive test results, 7 percent were hospitalized, and of these, 28 and 9 percent required intensive care unit services and mechanical ventilation, respectively.

"Future studies need to evaluate to what extent the higher rate of positive test results reflects different testing strategies across patient groups, as well as different social determinants of risk," a coauthor said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: November 2020

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