Eli Lilly and Company Indianapolis, Indiana, United States
Background: On March 2020, the Novel Coronavirus Disease (COVID-19) was declared a pandemic by the World Health Organization, and subsequently a national emergency was declared in the US concerning the outbreak.
Objectives: To characterize the epidemiology of COVID-19 in children in the US.
Methods: Medical claims of children ( <18 years old) enrolled in the IBM MarketScan database between April 1, 2020 and August 31, 2020 were analyzed to estimate the incidence (per 100 person-years) and period prevalence (percentage) rates of COVID-19 (ICD-10 diagnosis code U07.1) at inpatient and outpatient settings. The corresponding rates of any COVID-19 and hospitalized COVID-19 in overall sample, and among subgroups of children with diabetes (type 1, T1D [ICD-10 diagnosis code E10] and type 2, T2D [ICD-10 diagnosis code E11]) and asthma (ICD-10 diagnosis code J45) were calculated.
Results: During the 5-month analysis period, >5.3 million children were eligible for analysis (mean±SD age of 9±5.2 years; age groups: 30% <6 years, 39% 6-12 years, and 31% 13-17 years ; 51% males). About 0.2% of children had T1D (mean±SD age of 12.4±3.7 years; 53% males), 0.04% had T2D (mean±SD age of 13.2±3.9 years; 53% females), and 1.6% had asthma (mean±SD age of 10±4.6 years; 59% males). The prevalence rate of any COVID-19 and hospitalized COVID-19 among children were 0.3% and 0.004%, respectively. The corresponding incidence rates (per 100 person-years) were 0.66 (95%CI=0.65-0.67) and 0.009 (95%CI=0.008-0.01). The prevalence rates of the conditions among the age groups were: <6 years, 0.2% and 0.005%; 6-12 years, 0.2% and 0.002%; and 13-17 years, 0.4% and 0.005%. The related incidence rates among age groups were: <6 years, 0.46 and 0.01; 6-12 years, 0.51 and 0.005; and 13-17 years, 1.1 and 0.01 per 100 person-years. Females had slightly higher rates of any COVID-19 compared to males (prevalence, 0.3% vs. 0.2%; incidence, 0.69 vs. 0.64 per 100 person-years). The rates of any COVID-19 and hospitalized COVID-19 among children with pre-existing comorbidities of interest were as follows: T1D (prevalence, 0.5% and 0.1%; incidence, 17.5 and 5.52 per 100 person-years); T2D (prevalence, 1.5% and 0.6%; incidence, 133.8 and 78.4 per 100-person-years); and asthma (prevalence, 0.8% and 0.04%; incidence, 64.1 and 5.21 per 100 person-years). For reference, the prevalence and incidence (per 100 person-years) rates during same period among adults (≥18 years old) were (prevalence: 1.1% any COVID-19, 0.1% hospitalized COVID-19; incidence: 3.02 any COVID-19, 0.22 hospitalized COVID-19).
Conclusions: Pediatric population have lower prevalence and incidence rates of COVID-19 compared to adult general population. Nonetheless the rates are higher among children with pre-existing diabetes and asthma.
