Are Children At Risk Of Severe Complications And Death From COVID-19 Coronavirus?

By now you’ve been bombarded with news headlines about the “grave danger” to children posed by COVID-19 coronavirus. Reports of “unusual” illnesses related to the virus are swirling, too. But what is the real risk that your children might be killed or left damaged by COVID-19?

You may have seen a news report about a brand new study out of Rutgers University that claims to prove that the Chinese coronavirus is a serious health risk to children. This study claims that all children are at risk of severe complications and even death from COVID-19.

I’ve read the actual study. I’ve crunched the actual numbers, both in the study itself and those reported by the CDC and Johns Hopkins, among others. What the Rutgers study authors will tell you and what the actual data should tell you are different, at least in part.

To be sure, if you’re an obscure researcher toiling away in a lab somewhere, being able to publish a study report that makes a claim like “your children aren’t safe” will draw some attention to you and your work. It may even get some fawning attention from the press.

In this case, it should have done neither.

The description of the study in the media sounds alarming. 48 children ranging in age from newborn to 21 years old were studied after their admission to the Pediatric Intensive Care Unit (PICU.) A little scary, right?

Well, it would be, except they weren’t all admitted to the same PICU. 50 hospitals were participating in an information-sharing project. 46 of those hospitals, most in cities and urban locations, admitted children between March 14 and April 3, 2020. For those of you doing the math at home, that’s a three week span.

So an average of 16 kids per week were admitted to the PICU across 46 different hospitals. If we use averaging, that means that on virtually every day, the overwhelming majority of those hospitals saw not one single pediatric COVID-19 admission to PICU.

The numbers in the study description sound a little less scary now, right? Stay with me, it gets better.

If you do the math on the number of total cases and deaths from COVID-19 in the US, people under 24 make up no more than 0.13% of all deaths from the virus. As of May 2, about 56 Americans under the age of 24 had died from COVID-19 coronavirus. (Information derived from CDC and Johns Hopkins University)

Of that number, 40 of the 48 (83.33%) had preexisting comorbidities. They had underlying conditions such as respiratory conditions, obesity, diabetes, developmental disorders, cancer, immune compromises and cardiovascular disease. Several were post-transplant patients with severely compromised immune systems.

Does that mean kids are safe from the Chinese coronavirus? No. But it also means they have a far better shot at avoiding it all together than some Americans. For example, of the total COVID-19 deaths in the US, 79.88% were people over the age of 65. The majority of them also had underlying comorbidities.


Regarding the study, the kids who were admitted to PICU certainly were at risk. Anyone with COVID-19 is at risk. But if we’re going to worry about deaths in the 0-24 age group, other causes are more likely to kill those kids. Through May 2, seasonal flu for 2019-2020 had killed more than 150 kids in that age range.

For the record, I’m not one of those people who pretends this is not as bad as the flu. It’s a novel virus that human immune systems hadn’t encountered before Fall of 2019. That poses risks, some of which are linked to severe and often unusual complications.

I am, however, someone who believes that if science is to be of value to us in dealing with this crisis, it has to be honest and free of hyperbole and scare tactics. Unfortunately, that can’t be said for how this study is being presented by the scientific community and the media.

The truth about the Rutgers study was that it intended to describe the characteristics of seriously ill pediatric COVID-19 patients. The researchers wanted to determine the likelihood of recovery and response to various treatments, as well as how the children fared after recovery.

15 of the 48 children in the study were asymptomatic or had mild symptoms. Of the rest, 2 died. Of the children without underlying comorbidities, nearly all were asymptomatic. Almost 20 percent of the children experienced multiple organ failure and nearly 40 percent needed a ventilator. Serious stuff, to be sure.

At the end of the three week study period, almost a third of the children were still hospitalized, with three still needing ventilators. This is not a positive outcome, by any means.

Let’s not forget, however, that we aren’t talking about the results from a single hospital PICU over the course of a week or weekend. These results cover 48 kids checking into 46 different hospitals over a three week period. While that perspective should change the urgent and frightening response to the virus in kids, this study did tell us some important stories.

“This study provides a baseline understanding of the early disease burden of COVID-19 in pediatric patients,” said Hariprem Rajasekhar, a pediatric intensivist involved in conducting the study at Robert Wood Johnson Medical School’s Department of Pediatrics. “The findings confirm that this emerging disease was already widespread in March and that it is not universally benign among children.”

The team was “cautiously encouraged” by the hospital outcomes they observed. Among adults admitted to ICU’s, the reported mortality rate is as high as 62 percent. Among the children in this study, that rate was just 4.2 percent. They observed lower incidences of respiratory failure, too.

Study coauthor Lawrence C. Kleinman, professor and vice chair for academic development and chief of the Department of Pediatrics’ Division of Population Health, Quality and Implementation Science at Rutgers Robert Wood Johnson Medical School, did note one cause for concern that’s worth watching. Doctors in the New York metropolitan area have reported seeing what seems to be a new COVID-related syndrome in children.

“Although our data collection for this study has ended, we continue to develop collaborations with colleagues in our region and across the country to try to understand these more severe complications,” he said, citing concerns such as heart failure and the Kawasaki disease-like condition termed pediatric multi-system inflammatory syndrome as examples.

The bottom line here? A perfectly reasonable study got grabbed up by media and used as a headline about fear and panic. Some scientists were willing to go along, for whatever reason, and as a result, good science got turned into bad journalism.

Unfortunately, in our current political climate, bad journalism seems to be in no short supply. So when you see a scary or panicky headline, take a look behind it to see what’s there. Because while this new condition being seen in the NYC metro area may be something serious for us to keep an eye on, most of the news around COVID-19 and our kids is still pretty positive.

Keep the faith and keep after it!

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