Carried out by an international team of researchers from the UK and European nations including Spain and Austria, the study involved 582 patients aged 3 to 18 years.
The study spanned 82 specialist healthcare institutions across 25 European countries. It was conducted between 1 and 24 April, when the pandemic was at its peak in Europe, the researchers said.
According to the study, while 62 per cent of the patients were admitted to hospitals, only eight per cent required treatment in intensive care. However, the researchers also found that children who required a ventilator took longer than adults to be taken off the support. The case fatality rate — the percentage of study participants who died — was recorded at 0.69 per cent.
“Our study provides the most comprehensive overview of Covid-19 in children and adolescents to date. We were reassured to observe that the case fatality rate in our cohort was very low and it is likely to be substantially lower still, given that many children with mild disease would not have been brought to medical attention and therefore not included in this study,” Marc Tebruegge of University College London, the lead author of the study, said in a statement accompanying the study.
“Nevertheless, a notable number of children do develop severe disease and require intensive care support, and this should be accounted for when planning and prioritising healthcare resources as the pandemic progresses,” Tebruegge added.
Details of the study
Covid-19 is a respiratory ailment whose symptoms include fever, dry cough and tiredness, with some people likely to develop more severe forms of the disease like pneumonia.
Of the 582 patients, a quarter or around 25 per cent had pre-existing medical conditions.
The most common Covid-19 symptom reported was fever — with 379 patients experiencing it. Around half the patients had signs of upper respiratory tract infection, while a quarter had pneumonia.
Gastrointestinal symptoms were present in 128 (22 per cent) children. Of these, 40 patients did not have any respiratory symptoms. As many as 92 children had no symptoms at all.
Among the study participants, 87 per cent did not require oxygen or any other support to help them breathe at any stage.
Only 25 children needed mechanical ventilation. However, among those who did need ventilation, the support was often required for a prolonged period of a week or more.
Four patients died during the study period, two of whom had pre-existing medical conditions. All of the patients who died were older than 10 years of age.
Children may be affected by multiple respiratory viruses
As many as 29 children were found to be infected with one or more additional respiratory viruses at the same time as SARS-CoV-2, such as cold or flu viruses.
Of these, 24 per cent required intensive care, compared with 7 per cent among children with no additional viruses.
According to Begona Santiago-Garcia of Spain’s University Hospital Gregorio Marañón, one of the lead authors of the study, these findings may have important implications for the winter season, when cold and flu infections will be more common.
The researchers noted that, at the time that the study was conducted, many European countries were facing a shortage in testing capacity, which means that a lot of children with mild symptoms of Covid-19 would not have been diagnosed.
Different countries were using different criteria to screen for the SARS-CoV-2 virus, they said, adding that this lack of standardisation makes it difficult to generalise the findings to the wider population. However, they added that the true case fatality rate in children is likely lower than 0.69 per cent — as observed in this study.
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