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What do we know about infant mortality due to COVID-19?

This article was published on
May 6, 2021

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Experts conclude that severe illness from the coronavirus is still rare among children. However, some children might fall severely ill and immediate medical attention should be sought if a child shows symptoms. A child under the age of one year does not have a fully developed immune system and has smaller airways, so although rare, is more likely to fall severely ill. It is advised that caregivers wear masks and have clean hands around a newborn.

Experts conclude that severe illness from the coronavirus is still rare among children. However, some children might fall severely ill and immediate medical attention should be sought if a child shows symptoms. A child under the age of one year does not have a fully developed immune system and has smaller airways, so although rare, is more likely to fall severely ill. It is advised that caregivers wear masks and have clean hands around a newborn.

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What our experts say

Based on data available to the American Academy of Pediatrics and Children’s Hospital Association, 3.78 million children tested positive for COVID-19 infection by the end of April 2021.

Babies can get infected with COVID-19, but about a quarter of them show no symptoms and a majority show mild symptoms including cough, fever, breathing difficulty and/or gastrointestinal problems. Rarely, some children can become severely ill and might need hospitalization or intensive care treatment.

Studies have shown that some children who became ill with COVID-19 developed a condition called the Multisystem inflammatory syndrome in children (MIS-C). MIS-C is caused when there is an excessive immune system response to COVID-19, leading to parts of the body becoming severely inflamed. 

Babies under the age of one year are more at risk of severe illness than older children. This is because infant immune systems are not fully developed and their airways are smaller. It is recommended that during and after childbirth, caregivers wear masks and have clean hands when caring for newborns. Reasonable distance should be maintained from newborns when possible to reduce the risk of infection.

Further analysis is needed to determine mortality rates for children under 5 but studies show the rate may fall between 0.0 - 2%.

Context and background

There are several indirect threats to an infant’s survival that are posed by COVID-19. Routine healthcare disruption and seeking healthcare only when the child is seriously ill are some examples. Lack of testing can also lead to a delay in diagnosis and care. Comorbidities and socioeconomic vulnerabilities are also shown to be risk factors for mortality among hospitalized children. For example, malnutrition in children can adversely affect the immune response to fight the COVID-19 infection.

Resources

  1. Children and COVID-19: State-Level Data Report (American Academy of Pediatrics)
  2. COVID-19 could undermine progress towards reducing infant mortality (GAVI)
  3. Coronavirus infection in neonates: a systematic review (BMJ)
  4. COVID-19 (coronavirus) in babies and children (Mayo Clinic)
  5. Why are so many babies dying of Covid-19 in Brazil? (BBC)
  6. Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study (The Lancet)
  7. Noncommunicable Diseases, Sociodemographic Vulnerability, and the Risk of Mortality in Hospitalized Children and Adolescents with COVID-19 in Brazil: A Syndemic in Play (medRxiv)
  8. Child mortality and COVID-19 (UNICEF)
  9. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modeling study (The Lancet)

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