September 4, 2020

The hospitalization and death rates stemming from the novel coronavirus have been accelerating more quickly among children and adolescents than among the general public—and Black and Hispanic youth are disproportionately affected, according to new data from the American Academy of Pediatrics (AAP) and CDC.

How the coronavirus affects children, according to new research

Coronavirus cases among children rise

According to new data from AAP, the percentages of positive new coronavirus cases among children have increased in at least 49 states since the spring. Further, the percentage of total coronavirus cases among children as a share of the total number of reported cases among all ages in America more than doubled between May 21 and August 27, rising from about 4.2% of all reported cases to about 9.5%.

During the same time period, total cases among children rose from 54,031 to 476,439, while hospitalizations rose from 891 to 4,163, and deaths rose from 28 to 101.

According to the New York Times, there are some notable limitations to the data: Since states use different grouping categories—with many lumping teenagers and infants in the same category, and at least one grouping infants through young adults up to age 24 into one category—the data set may obfuscate differences in how the virus affects infants, children, and adolescents. (And despite the new data, children seem to contract and transmit the coronavirus less often than adults, and few children face severe infections or complications, according to the Times.)

That said, the recent increase in new coronavirus cases among youth remains consistent state-to-state, the Times reports. And while Sean O'Leary, vice chair of AAP's committee on infectious diseases, acknowledged that some of the increase in reported cases among youth may come from more widespread testing, he said the evidence indicates that children are being infected at a higher rate because, in addition to the increasing number of cases, there are higher rates of hospitalizations and deaths among minors, too.

"Anyone who has been on the front lines of this pandemic in a children's hospital can tell you we've taken care of lots of kids that are very sick," O'Leary said. "Yes, it's less severe in children than adults, but it's not completely benign."

Hispanic and Black children disproportionately affected

CDC data spanning from March 1 to July 25 that was collected from 14 states indicates that Black and Hispanic children under the age of 18 were infected with the coronavirus at higher rates than white children during that period—and they were hospitalized due to the virus at rates nearly five to eight times higher than white children.

Moreover, Black and Hispanic children accounted for a far greater proportion of the deaths linked to the novel coronavirus among children in those 14 states during that period when compared with white children, according to the CDC data.

In addition, according to the Times, children of color also accounted for most of the children hospitalized with multisystem inflammatory syndrome (MIS-C), a rare but deadly disease associated with the coronavirus. According to CDC research assessing 570 children with reported cases of MIS-C in 40 states; Washington, D.C.; and New York City as of July 29, of the children whose ethnicity was known, 40.5% were Hispanic, 33.1% were Black, and 13.2% were white.

That trend remains true in some areas outside of the United States, as well, as a study published last week in BMJ found that Black children in the United Kingdom who were infected with the coronavirus were both more likely to be moved to critical care and more likely to develop MIS-C than white children.

Further, CDC's data also suggests that, among children hospitalized for Covid-19 in 14 states from March 1 to July 25, Hispanic and Black children were more likely than white children to have underlying health conditions. Specifically, 45% of Hispanic children hospitalized for Covid-19 had an underlying health condition, as did 29% of Black children—compared with 15% of white children.

According to Monika Goyal, a pediatric emergency medicine specialist at Children's National Hospital, the reason children of color are disproportionately affected by the coronavirus is likely a result of increased exposure to the virus based on their living situations—not because of "some sort of genetic predisposition to Covid based on race or ethnicity."

Jose Figueroa—an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health, who has helped conduct research indicating that coronavirus infection rates are higher in communities with greater numbers of immigrants, food industry professionals, and people living in shared housing—pointed out that immigrants also could be hesitant to seek medical care, and those working in the food service industry may not have access to paid sick leave. As a result, their children may be at increased risk of infection, Figueroa explained.

"What you have is the perfect recipe for fast transmission of Covid-19 in the Latino community," he said. "Working adults who keep going to work because they need to put food on the table and pay the rent, and who often have young children" (Leatherby/Jones, New York Times, 8/31; Budryk, The Hill, 8/31; Rabin, New York Times, 9/1).

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