Major German Academic Medical Center Study: No Healthy Children Have Died Due to SARS-CoV-2
A team of German scientists from prominent academic medical centers including Car Gustav Carus, Technical University (Dresden); Ludwig-Maximilian-University (Munich), and Heidelberg University (Heidelberg) conducted an observational study to better understand the risks associated with COVID-19 in children. Leveraging data from the SARS-CoV-2 KIDS study as well as data from a nationwide registry on hospitalized children with COVID-19 and Pediatric Inflammatory Multisystem Syndrome—Temporarily-Associated with SARS-CoV-2 (PIMS-TS), the study was sponsored by the German Society for Pediatric Infectious Diseases (DGPI). The investigators combined data in a bid to validate the risk assessment involving hospitalization, intensive care (ICU) admission, and death associated with the novel coronavirus as well as PIMS-TS for children in various age groups—based on vaccination eligibility cohorts in Germany. The study findings are based on data with several assumptions which must be factored into the bombshell results. Moreover, this study was just recently published in the medRxiv preprint and hasn’t been verified by the peer-review process yet. But nonetheless, the findings raise just a few questions associated with the benefit-risk analysis involving the mass vaccination of children aged 5 to 11.
What did the team find?
In Germany among the data accessible, the investigators discovered a SARS-CoV-2 infection rate of 35.9 per 10,000 children. Interestingly, the ICU rate was far lower at 1.7 per 10,000 and the case fatality rate equaled 0.9 per 10,000. The authors found that “Children without comorbidities were found to be significantly less likely to suffer from a severe or fatal disease course.”
In the cohort 5-11 years of age, the lowest risk group became apparent based on the observational study findings. In this latter group, the ICU admission rate equaled 0.2 per 10,000, and case fatality rates couldn’t be calculated—there were no deaths reported.
When it came to PIMS-TS, the rate emerged at 1 per 4,000 SARS-CoV-2 infections. Most of these cases involved children without comorbidities.
Conclusion
This study, led by researchers from some of Germany’s most prominent academic medical centers, found that “the SARS-CoV-2 associated burden of a severe disease group or death in children and adolescents is low.” This observation is a strong and consistent pattern across 5- to 11-year-old children not struggling with comorbidities. The authors do not, however, feel that PIMS-TS can impact disease burden across age groups.
The study team suggests that approximately 3% of all children in Germany have one or more relevant comorbidities and thus, an increased risk of COVID-19. Importantly, the authors couldn’t find a single death due to COVID-19 involving a healthy child. The data in this study is comparable to the standards of other important seroprevalence estimates around the world.
Limitations
This study is observational and hence shouldn’t be used as primary evidence
Uncertainty in the data based on the three different sources (estimates)
Possible selection bias
ELISA cut-off values
Precision & the suitability of IgG detected by ELISA to depict COVID-19 infections in children
Lead Research/Investigator
Jakob Armann, Carl Gustav Carus, Technical University, Department of Pediatrics, University Hospital and Medical Faculty, Department of Pediatrics, University Hospital and Medical Faculty, Corresponding Author
Al Sorg, Ludwig-Maximilian-University, Munich, Institute of Social Pediatrics and Adolescent Medicine, Division of Pediatric Epidemiology
M Hufnagel, University of Freiburg, Freiburg, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases and Rheumatology
M Doenhardt, Carl Gustav Carus, Technical University, Department of Pediatrics, University Hospital and Medical Faculty
N Diffloth, Carl Gustav Carus, Technical University, Department of Pediatrics, University Hospital and Medical Faculty
H Schrotein, Heidelberg University, Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty
R v. Kries, Ludwig-Maximilian-University, Munich, Institute of Social Pediatrics and Adolescent Medicine, Division of Pediatric Epidemiology
R Berner, Ludwig-Maximilian-University, Munich, Institute of Social Pediatrics and Adolescent Medicine, Division of Pediatric Epidemiology
Call to Action: This study has profound implications for the mass vaccination of children. An accurate and comprehensive benefit-risk analysis must be better understood in the context of the true threat of the novel coronavirus (SARS-CoV-2 and all its variants) to children (hospitalization and mortality) and the threat of adverse events associated with the vaccines as compared to the benefits.
Risk of Hospitalization, severe disease, and mortality due to COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany