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COVID-19 and Kids: More Than 338,980 Cases Reported

Complications can strike the young, and Black, Hispanic children hospitalized at higher rates

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Noam Galai / Getty Images

As young students across the country head back to school — both virtually and in person — several new reports show that kids are not immune to the coronavirus, nor are they invulnerable to the complications it can cause.

More than 338,980 kids in the U.S. have tested positive for the new coronavirus (SARS-CoV-2) through July 30, according to data from the American Academy of Pediatrics and the Children's Hospital Association. About 97,000 of the cases were in the last two weeks of July. California, Florida, Arizona and Tennessee reported the most cases of COVID-19 in kids. Half of all U.S. states recorded at least 5,000 cases apiece.

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And while most kids who acquire a coronavirus infection experience no symptoms or mild ones, an analysis from the Centers for Disease Control and Prevention (CDC) of 576 children across 14 states who were hospitalized for COVID-19 found that 1 in 3 pediatric patients were admitted to the intensive care unit (ICU), which is similar to the proportion among adults. The most common symptoms among hospitalized kids were fever and chills, followed by gastrointestinal symptoms, including nausea or vomiting, and abdominal pain or diarrhea.

Hispanic, Black children bear disproportionate burden

The CDC report also found that similar to trends seen in adults, Black and Hispanic children were hospitalized at higher rates than white children. Hispanic children were about eight times more likely to be hospitalized with COVID-19 than white children, and Black children were about five times more likely to be hospitalized, compared to their white peers.

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The reasons for the racial and ethnic disparities in hospitalizations associated with COVID-19 are not fully understood, the report's authors note. “It has been hypothesized that Hispanic adults might be at increased risk for SARS-CoV-2 infection because they are overrepresented in frontline (e.g., essential and direct-service) occupations with decreased opportunities for social distancing, which might also affect children living in those households,” they write.

Underlying health conditions may also play a role. Among the hospitalized children for whom there was information on underlying medical conditions, about 42 percent had one or more underlying health condition, the most common of which was obesity. Hispanic and Black children had higher prevalence of underlying conditions (45.7 percent and 29.8 percent, respectively) compared with white children (14.9 percent), the CDC report found.

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Some kids with COVID-19 develop rare but serious syndrome

Some children are also falling ill with a rare but serious inflammatory disease related to the coronavirus, called multisystem inflammatory syndrome in children (MIS-C). From March to late July, the CDC received 570 reported cases of MIS-C, which presents with features similar to Kawasaki disease. (Kawasaki disease is an illness that causes inflammation in the walls of some blood vessels in the body, most commonly in children under age 5.)

Most MIS-C cases documented in the CDC report included features of shock, cardiac dysfunction, gastrointestinal symptoms, elevated markers of inflammation and cardiac damage. Nearly 64 percent of the MIS-C patients required intensive care; 10 patients died. About 40 percent of pediatric patients were Hispanic and about 33 percent were Black. Comparatively, about 13 percent of MIS-C patients were white.

The authors of the CDC report call for “reinforcement of prevention efforts” in settings that serve children, such as childcare centers and schools. According to the CDC, minimizing exposure through physical distancing and mask wearing are two ways to prevent a coronavirus infection. Handwashing and frequent cleaning of high-touch surfaces are also recommended.

Greater prevention efforts will also help protect adults who are in frequent contact with children during the pandemic. Data from the Kaiser Family Foundation shows that nearly 1.5 million teachers (about 1 in 4) are at increased risk for serious illness from a coronavirus infection, based on their age and underlying health conditions. What's more, about 3.3 million Americans who are 65 or older (about 6 percent) lived in a household with child age 5 to 18 in 2018.

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