SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people: birth cohort study

Pia Hardelid; Graziella  Favarato; Linda Wijlaars; Lynda Fenton; Jim McMenamin; Tom Clemens; Chris Dibben; Ai Milojevic; Alison   Macfarlane; Jonathon Taylor; Steve Cunningham; Rachael Wood

doi:10.1136/bmjpo-2022-001545

SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people: birth cohort study

Pia Hardelid^*, Graziella Favarato, Linda Wijlaars, Lynda Fenton, Jim McMenamin, Tom Clemens, Chris Dibben, Ai Milojevic, Alison Macfarlane, Jonathon Taylor, Steve Cunningham, Rachael Wood

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Background
There have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years.

Methods
We used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100,000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors.

Results
Among the 1226855 CYP in the cohort, there were 378,402 tests (a rate of 770.8/1000 CYP years (95% confidence interval [768.4-773.3]), 19,005 PCR confirmed infections (179.4/1000 CYP years [176.9-182.0]) and 346 admissions (29.4/100,000CYP years [26.3-32.8]). Infants had the highest COVID-19-related admission rates. Chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. Overall, 49% of admitted CYP had at least one chronic condition recorded.

Conclusions
Infants, and CYP with chronic conditions are at highest risk of admission with COVID-19. Half of admitted CYP had chronic conditions. Studies examining COVID vaccine effectiveness among children with chronic conditions, and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed.

Original language	English
Article number	e001545
Journal	BMJ Paediatrics Open
Volume	6
Issue number	1
Early online date	29 Aug 2022
DOIs	https://doi.org/10.1136/bmjpo-2022-001545
Publication status	Published - 29 Aug 2022

Keywords / Materials (for Non-textual outputs)

Adolescent
Birth Cohort
COVID-19 Testing
COVID-19 Vaccines
COVID-19/diagnosis
Child
Chronic Disease
Cohort Studies
Female
Hospitals
Humans
Infant
Pregnancy
SARS-CoV-2

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10.1136/bmjpo-2022-001545

bmjpo-2022-001545
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Final published version, 438 KBLicence: Creative Commons: Attribution (CC-BY)

https://pubmed.ncbi.nlm.nih.gov/36053647/Licence: Creative Commons: Attribution (CC-BY)

Cite this

Hardelid, P., Favarato, G., Wijlaars, L., Fenton, L., McMenamin, J., Clemens, T., Dibben, C., Milojevic, A., Macfarlane, A., Taylor, J., Cunningham, S., & Wood, R. (2022). SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people: birth cohort study. BMJ Paediatrics Open, 6(1), Article e001545. https://doi.org/10.1136/bmjpo-2022-001545

@article{83deeeda07594a1f9d2a2db7ae94fb1f,

title = "SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people: birth cohort study",

abstract = "BackgroundThere have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years. MethodsWe used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100,000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors.ResultsAmong the 1226855 CYP in the cohort, there were 378,402 tests (a rate of 770.8/1000 CYP years (95% confidence interval [768.4-773.3]), 19,005 PCR confirmed infections (179.4/1000 CYP years [176.9-182.0]) and 346 admissions (29.4/100,000CYP years [26.3-32.8]). Infants had the highest COVID-19-related admission rates. Chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. Overall, 49% of admitted CYP had at least one chronic condition recorded.ConclusionsInfants, and CYP with chronic conditions are at highest risk of admission with COVID-19. Half of admitted CYP had chronic conditions. Studies examining COVID vaccine effectiveness among children with chronic conditions, and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed. ",

keywords = "Adolescent, Birth Cohort, COVID-19 Testing, COVID-19 Vaccines, COVID-19/diagnosis, Child, Chronic Disease, Cohort Studies, Female, Hospitals, Humans, Infant, Pregnancy, SARS-CoV-2",

author = "Pia Hardelid and Graziella Favarato and Linda Wijlaars and Lynda Fenton and Jim McMenamin and Tom Clemens and Chris Dibben and Ai Milojevic and Alison Macfarlane and Jonathon Taylor and Steve Cunningham and Rachael Wood",

note = "Funding Information: We are grateful to Professor Bianca De Stavola (UCL) for her advice on statistical modelling. The authors would like to acknowledge the support of the eDRIS Team (Public Health Scotland), and particularly Diane Rennie, for their involvement in obtaining approvals, provisioning and linking data and the use of the secure analytical platform within the National Safe Haven. This work uses data provided by patients and collected by the NHS as part of their care and support. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.",

year = "2022",

month = aug,

day = "29",

doi = "10.1136/bmjpo-2022-001545",

language = "English",

volume = "6",

journal = "BMJ Paediatrics Open",

issn = "2399-9772",

publisher = "BMJ Publishing Group",

number = "1",

}

Hardelid, P, Favarato, G, Wijlaars, L, Fenton, L, McMenamin, J, Clemens, T , Dibben, C, Milojevic, A, Macfarlane, A, Taylor, J, Cunningham, S & Wood, R 2022, 'SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people: birth cohort study', BMJ Paediatrics Open, vol. 6, no. 1, e001545. https://doi.org/10.1136/bmjpo-2022-001545

TY - JOUR

T1 - SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people

T2 - birth cohort study

AU - Hardelid, Pia

AU - Favarato, Graziella

AU - Wijlaars, Linda

AU - Fenton, Lynda

AU - McMenamin, Jim

AU - Clemens, Tom

AU - Dibben, Chris

AU - Milojevic, Ai

AU - Macfarlane, Alison

AU - Taylor, Jonathon

AU - Cunningham, Steve

AU - Wood, Rachael

N1 - Funding Information: We are grateful to Professor Bianca De Stavola (UCL) for her advice on statistical modelling. The authors would like to acknowledge the support of the eDRIS Team (Public Health Scotland), and particularly Diane Rennie, for their involvement in obtaining approvals, provisioning and linking data and the use of the secure analytical platform within the National Safe Haven. This work uses data provided by patients and collected by the NHS as part of their care and support. Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

PY - 2022/8/29

Y1 - 2022/8/29

N2 - BackgroundThere have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years. MethodsWe used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100,000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors.ResultsAmong the 1226855 CYP in the cohort, there were 378,402 tests (a rate of 770.8/1000 CYP years (95% confidence interval [768.4-773.3]), 19,005 PCR confirmed infections (179.4/1000 CYP years [176.9-182.0]) and 346 admissions (29.4/100,000CYP years [26.3-32.8]). Infants had the highest COVID-19-related admission rates. Chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. Overall, 49% of admitted CYP had at least one chronic condition recorded.ConclusionsInfants, and CYP with chronic conditions are at highest risk of admission with COVID-19. Half of admitted CYP had chronic conditions. Studies examining COVID vaccine effectiveness among children with chronic conditions, and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed.

AB - BackgroundThere have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years. MethodsWe used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100,000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors.ResultsAmong the 1226855 CYP in the cohort, there were 378,402 tests (a rate of 770.8/1000 CYP years (95% confidence interval [768.4-773.3]), 19,005 PCR confirmed infections (179.4/1000 CYP years [176.9-182.0]) and 346 admissions (29.4/100,000CYP years [26.3-32.8]). Infants had the highest COVID-19-related admission rates. Chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. Overall, 49% of admitted CYP had at least one chronic condition recorded.ConclusionsInfants, and CYP with chronic conditions are at highest risk of admission with COVID-19. Half of admitted CYP had chronic conditions. Studies examining COVID vaccine effectiveness among children with chronic conditions, and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed.

KW - Adolescent

KW - Birth Cohort

KW - COVID-19 Testing

KW - COVID-19 Vaccines

KW - COVID-19/diagnosis

KW - Child

KW - Chronic Disease

KW - Cohort Studies

KW - Female

KW - Hospitals

KW - Humans

KW - Infant

KW - Pregnancy

KW - SARS-CoV-2

U2 - 10.1136/bmjpo-2022-001545

DO - 10.1136/bmjpo-2022-001545

M3 - Article

C2 - 36053647

SN - 2399-9772

VL - 6

JO - BMJ Paediatrics Open

JF - BMJ Paediatrics Open

IS - 1

M1 - e001545

ER -

SARS-CoV-2 tests, confirmed infections and COVID-19 related hospital admissions in children and young people: birth cohort study

Abstract / Description of output

Keywords / Materials (for Non-textual outputs)

Access to Document

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