Stepwise School Opening Online and Off-line and an Impact on the Epidemiology of COVID-19 in the Pediatric Population

Background Data on SARS-CoV-2 transmission from a pediatric index patient to others at the school setting are limited. Epidemiologic data on pediatric COVID-19 cases after school opening is warranted. Methods We analyzed data of the pediatric patients with COVID-19 collected from the press release of the Korea Centers for Disease Control and Prevention. Information on the school opening delay and re-opening policies were achieved from the press release from Korean Ministry of Education. Findings The school openings were delayed three times in March 2020. Online classes started from April 9, and off-line classes started from May 20 to June 8 at four steps in different grades of students. There was no sudden increase in pediatric cases after the school opening, and the proportion of pediatric cases remained around 7.0% to 7.1%. As of July 11, 45 children from 40 schools and kindergartens were diagnosed with COVID-19 after off-line classes started. More than 11,000 students and staff were tested; only one additional student was found to be infected in the same classroom. Among those 45, 32 (71.1%) patients had available information for the source of infection. Twenty-five (25/45, 55.6%) were infected by the family members. The proportions of pediatric patients without information on infection sources were higher in older age group (middle and high school students) than in younger age group (kindergarten and elementary school students) (47.6% vs 12.5%, p=0.010). In the younger age group, 79.1% of children were infected by family members, while only 28.6% of adolescents in the older age group were infected by family members (p<0.001). Interpretation Korea had a successful transition from school closure to re-opening with online and off-line classes. Although partial, off-line school opening did not cause significant school-related outbreak among pediatric population although young children and adolescents may have different epidemiologic features.

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A Phase I Study to Investigate the Safety, Tolerability, and Pharmacokinetics/Pharmacodynamics of Tripegfilgrastim (Dulastin®) after Single Administration in Pediatric Patients

Blood ◽

10.1182/blood-2019-125266 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 3594-3594

Author(s):

Kyung Taek Hong ◽

Soyoung Lee ◽

Jaeseong Oh ◽

Jung Yoon Choi ◽

Hee Young Shin ◽

...

Keyword(s):

Phase I ◽

Solid Tumors ◽

Pediatric Patients ◽

Conflicts Of Interest ◽

Older Age ◽

Age Group ◽

Younger Age ◽

Number Of Patients ◽

Significant Difference ◽

The Mean

Introduction: Chemotherapy-induced neutropenia (CIN) is one of main complications following systemic chemotherapy, which can cause many kinds of opportunistic infections. To overcome CIN, granulocyte colony stimulating factor (G-CSF) is usually administered to reduce neutropenic period. Tripegfilgrastim (Dulastin®) is one of pegfilgrastim drugs, which was approved for adult CIN by Korea Ministry of Food and Drug Safety in 2014. Methods: We have conducted a phase I, open-label, single ascending dose study to investigate the pharmacokinetics, safety, tolerability and pharmacodynamics of Tripegfilgrastim in pediatric patients with lymphoma or solid tumors. The patients were divided by dose of Tripegfilgrastim (60 μg/kg [lower dose, LD] and 100 μg/kg [higher dose, HD]) and age (6≤ and <12 years versus 12≤ and <19 years). Total planned number of patients was 32; 8 patients in each groups. Tripegfilgrastim was injected subcutaneously at 24 hours after the end of chemotherapy, and serial pharmacokinetic/pharmacodynamics blood samplings and safety monitoring were conducted. The trial was registered at ClinicalTrials.gov, NCT02963389. This study was supported by Dong-A ST Co., Ltd., Seoul, Republic of Korea. Results: Twenty-seven patients enrolled on this study, including 4 in LD and younger age group, 7 in LD and older age group, 8 in HD and younger age group, and 8 in HD and older age group. Six malignant germ cell tumors, 5 non-rhabdomyosarcoma soft tissue sarcomas, 4 osteosarcomas, 3 rhabdomyosarcomas, 3 neuroblastomas, 2 medulloblastomas, and 4 others were included. All enrolled patients had previously received the same-regimen chemotherapy, which had induced grade 4 neutropenia. Due to insufficient pharmacodynamics by interim analysis in some patients of LD groups, these were early closed and subsequent enrolled patients received HD of Tripegfilgrastim. The maximum concentration (Cmax) and area under the curve until 312 hours (AUC0-312h) were 89.57 ± 40.97 μg/L and 8371.99 ± 4773.29 μg∙h/L in LD group, and 130.15 ± 72.04 μg/L, 11977.40 ± 7572.29 μg∙h/L in HD group, respectively. The peak concentration was achieved at 24 hours after injection, and the Cmax and AUC0-312h of HD group were increased by 45% compared with LD group. The half-life, clearance, and volume of distribution were 47.22 hours, 0.45 L/h, 28.1 L in LD group, 40.78 hours, 0.52 L/h, 28.78 L in HD group, respectively. When these pharmacokinetics parameters were compared with our previous results of healthy adult volunteers, Cmax of LD group was similar to adult 3.6 mg injection, while Cmax and AUC0-312h of HD group were 36% and 50% of those of adult 6.0 mg injection. To investigate the pharmacodynamics, days when the absolute neutrophil count (ANC) is above 1,000/μL (T above ANC 1000), and days when ANC is below 500/μL (T below ANC 500) were evaluated. The mean T above ANC 1000 (range, days) were 7.1 days (1.6-13.6) in LD group, and 9.3 days (3.4-13.7) in HD group, respectively. Furthermore, the mean T below ANC 500 (range, days) were 4.4 days (0-10.8) in LD group, and 2.5 days (0-10.1) in HD group, respectively, which showed better pharmacodynamics in HD group. However, high inter-patient variability was observed. There was no significant difference between younger and older age groups in each LD and HD groups. There were 2 adverse drug reactions (7.4%) related to Tripegfilgrastim, which were grade 1 back pain and grade 2 arthralgia. Three severe adverse events occurred (2 bacteremia and 1 skin lesion), which resolved with further treatments. Conclusions: Tripegfilgrastim have shown safety and tolerability in pediatric patients between 6 to 19 years old with solid tumors. The pharmacokinetics parameters, Cmax and AUC0-312h of HD group were increased by 45% compared with LD group, which translates into the better pharmacodynamics parameters of HD group without increasing toxicity. Our results suggests that Tripegfilgrastim 100 μg/kg once injection could be feasible to reduce CIN in pediatric patients. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Tripegfilgrastim to investigate the safety, tolerability, and pharmacokinetics/pharmacodynamics

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Paranasal Mass in a Healthy Male Toddler

Ear Nose & Throat Journal ◽

10.1177/01455613211007944 ◽

2021 ◽

pp. 014556132110079

Author(s):

Melonie Anne Phillips ◽

Meredith Lind ◽

Gerd McGwire ◽

Diana Rodriguez ◽

Suzanna Logan

Keyword(s):

Differential Diagnosis ◽

Pediatric Patients ◽

Pediatric Population ◽

Age Group ◽

Significant Morbidity ◽

Healthy Male ◽

Neck Tumors ◽

Complete Surgical Resection ◽

Maxilla And Mandible ◽

Benign Mass

Head and neck tumors are rare in pediatric patients but should be kept in the differential when a patient presents with a new swelling or mass. One of these tumors is a myxoma, which is an insidiously growing, benign mass originating from the mesenchyme. They most commonly arise in the myocardium but can also develop in facial structures, particularly in the maxilla and mandible. When arising in facial structures, ocular, respiratory, and digestive systems can be affected based on local invasion. Complete surgical resection is curative but can lead to significant morbidity as well. Here, we present a case of a 15-month-old toddler presenting with a paranasal mass, which was ultimately diagnosed as a maxillary myxoma. This tumor is very rare in the pediatric population, especially in the toddler age-group, reminding clinicians to broaden the differential diagnosis when a patient’s course is atypical.

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Opioid Prescribing Patterns for Low Back Pain Among Commercially Insured Children

Neurosurgery ◽

10.1093/neuros/nyz310_203 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Tej D Azad ◽

Michael D Harries ◽

Daniel Vail ◽

Yi Jonathan Zhang ◽

John K Ratliff

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pediatric Patients ◽

Pediatric Population ◽

Prescribing Patterns ◽

Low Back ◽

Age Group ◽

Newly Diagnosed ◽

Opioid Prescription ◽

Opioid Prescribing

Abstract INTRODUCTION Low back pain (LBP) may affect up to 20% of the pediatric population. No specific guidelines exist regarding pharmacotherapy for acute LBP in the pediatric population. Given this observation and the lack of data available regarding pharmacotherapy for pediatric LBP, we sought to characterize patterns of opioid prescribing in the pediatric population. METHODS We used a national database to identify pediatric patients (age 5-17) with newly diagnosed with LBP between 2008 and 2015 who did not have a red flag diagnosis, had not received an opioid prescription in the 6 mo prior to diagnosis, and had 12-mo of continuous enrollment after diagnosis. We used logistic regression to model the association between sex, geographic region, categorical age, and our primary outcome, receipt of an opioid prescription in the year following diagnosis. RESULTS Our sample included 268 228 opioid-naïve pediatric patients diagnosed with LBP between 2008 and 2015. We observed that 47 631 (17.8%) patients received physical therapy, 29 903 (11.2%) patients received chiropractic manipulative therapy, 658 (0.25%) patients received epidural steroid injection, and 281 (0.10%) patients received surgery. A total of 35 274 (13.2%) pediatric LBP patients were prescribed opioids within 12 mo from their diagnosis. Opioid prescribing decreased in all age groups over the study period age group 5 to 9 decreased from 4.2% to 2.7%, age group 10 to 14 decreased from 10.3% to 7.7%, and age group 15 to 18 yr decreased from 20.9% to 17.1%. Female pediatric patients were more likely than male patients to receive an opioid prescription (OR, 1.12, P < .0001). Patients ages 10 to 14 (OR, 2.89, P < .0001) and 15 to 18 (OR, 6.98, P < .0001) were significantly more likely to be prescribed opioids compared to patients in the youngest age group. CONCLUSION To our knowledge, we report the first observational cohort study of opioids and LBP in the pediatric population. Our findings indicate that opioids are being used for newly diagnosed LBP and receipt of opioids are associated with patient demographic factors.

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Symptomatic Dystonia: Clinical Profile of 46 Brazilian Patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100041718 ◽

1992 ◽

Vol 19 (4) ◽

pp. 504-507 ◽

Cited By ~ 17

Author(s):

Henrique B. Ferraz ◽

Luiz Augusto F. Andrade

Keyword(s):

Muscle Contraction ◽

Older Age ◽

Cerebral Injury ◽

Clinical Profile ◽

Age Group ◽

Mitochondrial Cytopathy ◽

Cranial Trauma ◽

Tardive Dystonia ◽

Younger Age ◽

Symptomatic Dystonia

ABSTRACT:Dystonia is a syndrome characterized by sustained muscle contraction, provoking twisting and repeti-tive movements or abnormal postures. It may be classified according to etiology, as idiopathic or symptomatic. We studied 122 Brazilian patients with a dystonic syndrome. Of these, 46 (37.7%) had symptomatic dystonia. The most frequent cause was tardive dystonia (34.8%) followed by perinatal cerebral injury (30.4%). Other causes were stroke (13.0%), encephalitis (6.5%) and Wilson’s disease (4.3%). Cranial trauma, mitochondrial cytopathy and psychogenic, were the least frequent causes with one patient in each category. The etiology in two patients could not be established. Perinatal cerebral injury and postencephalitic dystonia were seen in the younger age group, while post-stroke and tardive dystonia were seen in the older age group.

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Analysis of Warfarin Therapy in Pediatric Patients: A Prospective Cohort Study of 319 Patients

Blood ◽

10.1182/blood.v94.9.3007 ◽

1999 ◽

Vol 94 (9) ◽

pp. 3007-3014 ◽

Cited By ~ 200

Author(s):

W. Streif ◽

M. Andrew ◽

V. Marzinotto ◽

P. Massicotte ◽

A.K.C. Chan ◽

...

Keyword(s):

Enteral Nutrition ◽

Warfarin Therapy ◽

Pediatric Patients ◽

Pediatric Population ◽

International Normalized Ratio ◽

Target Range ◽

Age Group ◽

Older Children ◽

Effect Of Age ◽

Fontan Patients

Abstract This study details warfarin use in a large pediatric population followed in a central anticoagulation clinic. A prospective, consecutive cohort of nonselected children were studied. Patients were divided into groups by age, target international normalized ratio (INR) range, disease, medications, and vitamin K supplemented enteral nutrition use. Groups were analyzed on multiple aspects of warfarin therapy using multivariate methods. A total of 319 patients received 352 warfarin courses representing 391 treatment years. Age independently influenced all aspects of therapy. When compared with all older children, the ≤1 year of age group required increased warfarin doses, longer overlap with heparin, longer time to achieve target INR ranges, more frequent INR testing and dose adjustments, and fewer INR values in the target range. Although significantly different than children ≤1 year, children 1 to 6 years of age showed the same findings when compared with 7- to 18-year-olds. Fontan patients required 25% decreased dosage as compared with other congenital heart disease patients. Children on corticosteroids had less INRs in the target range and children on phenobarbital/carbamazepine required increased maintenance dosages of warfarin. Also, patients receiving enteral nutrition required increased dosages of warfarin. Serious bleeding occurred in 2 children (0.5% per patient year). Recurrent thromboembolic events (TEs) occurred in 8 children. Two children had recurrences while receiving warfarin (1.3% per patient year). This study outlines the profound effect of age and relative complexity of clinical management of warfarin therapy in children.

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Comparison of anthropometric data quality in children aged 6-23 and 24-59 months: lessons from population-representative surveys from humanitarian settings

BMC Nutrition ◽

10.1186/s40795-020-00385-0 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Oleg Bilukha ◽

Alexia Couture ◽

Kelly McCain ◽

Eva Leidman

Keyword(s):

Data Quality ◽

Age Groups ◽

Older Age ◽

Demographic And Health Surveys ◽

Age Group ◽

Anthropometric Data ◽

Digit Preference ◽

Anthropometric Indicators ◽

Younger Age

Abstract Background Ensuring the quality of anthropometry data is paramount for getting accurate estimates of malnutrition prevalence among children aged 6–59 months in humanitarian and refugee settings. Previous reports based on data from Demographic and Health Surveys suggested systematic differences in anthropometric data quality between the younger and older groups of preschool children. Methods We analyzed 712 anthropometric population-representative field surveys from humanitarian and refugee settings conducted during 2011–2018. We examined and compared the quality of five anthropometric indicators in children aged 6–23 months and children aged 24–59 months: weight for height, weight for age, height for age, body mass index for age and mid-upper arm circumference (MUAC) for age. Using the z-score distribution of each indicator, we calculated the following parameters: standard deviation (SD), percentage of outliers, and measures of distribution normality. We also examined and compared the quality of height, weight, MUAC and age measurements using missing data and rounding criteria. Results Both SD and percentage of flags were significantly smaller on average in older than in younger age group for all five anthropometric indicators. Differences in SD between age groups did not change meaningfully depending on overall survey quality or on the quality of age ascertainment. Over 50% of surveys overall did not deviate significantly from normality. The percentage of non-normal surveys was higher in older than in the younger age groups. Digit preference score for weight, height and MUAC was slightly higher in younger age group, and for age slightly higher in the older age group. Children with reported exact date of birth (DOB) had much lower digit preference for age than those without exact DOB. SD, percentage flags and digit preference scores were positively correlated between the two age groups at the survey level, such as those surveys showing higher anthropometry data quality in younger age group also tended to show higher quality in older age group. Conclusions There should be an emphasis on increased rigor of training survey measurers in taking anthropometric measurements in the youngest children. Standardization test, a mandatory component of the pre-survey measurer training and evaluation, of 10 children should include at least 4–5 children below 2 years of age.

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Study of Lipid Profile and Coronary Angiographic Pattern in Young Bangladeshi Patients with Acute Coronary Syndrome

Cardiovascular Journal ◽

10.3329/cardio.v1i2.8237 ◽

1970 ◽

Vol 1 (2) ◽

pp. 183-188 ◽

Cited By ~ 1

Author(s):

AR Khan ◽

AAS Majumder

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Lipid Profile ◽

Older Age ◽

Age Group ◽

Coronary Angiogram ◽

Coronary Syndrome ◽

Group I ◽

Younger Age ◽

Group Ii

Background: Majority of the patients of coronary heart disease (CHD) in our country are above 40 years of age but a good number of patients belong to the age under 40, the most valuable and productive period of life during which they can devote themselves to uplift their family, society and country and can participate in nation building activities.3,4 The number of young individuals falling into the spectrum of CHD is increasing everywhere However, this age trend is peculiar in relation to the western age incidence.5 Our objective was to investigate the lipid profile and coronary angiographic pattern in young Bangladeshi patients with acute coronary syndrome and also to find out the relationship between dyslipidemia and coronary artery disease in this age group. Methods: This observational study was carried out in National Institute of Cardiovascular Diseases (NICVD) during the period of January 2000 to December 2000. A brief history was recorded on the date of admission and fasting lipid profile was done within 24 hours of admission. Other associated major risk factors were looked for and recorded accordingly. After stabilization oh the acute condition patient was prepared for coronary angiogram and informed consent was taken. Accordingly elective CAG was done. Among them total 64 patients of ACS, underwent coronary angiogram in the cath lab of NICVD, were selected randomly of which of which 32 patients were up to the age 40 years (Group- I) and 32 were above 40 years of age (Group-II). Patient of ACS of either sex having no age limitation were included without prior history of Percutaneous Coronary Intervention or Coronary Artery Bypass Graft surgery. The findings were reviewed and scrutinized carefully by two interventional cardiologists. In doubtful cases third expert reviewed the CD. If a consensus was not reached due to technical or visual error, the case wais discarded from the study. Details of CAG findings i.e. site and number of diseased vessels, location, morphology and pattern of lesion were studied and recorded accordingly. Results: The prevalence of dyslipidaemia and positive family history were more in group I than group II. Younger age group has less favorable lipid profile than older age group having raised total cholesterol in 31.3 percent cases, low HDL in 12.5 percent cases and raised LDL in 31.3 percent cases, while in older age group, it was 21.8, 25.0, 0 and 18.7 percent, respectively. CAG study of the patients showed that no vessel involvement was more common in group I than group II (21.9% vs 12.5%), but triple vessel disease was more common in group II (12.5% vs 21.8%). Single vessel and double vessel diseases were similar in both the groups. Involvement of LAD was slightly more in-group I than group II (68.8% vs 65.6%) and involvement of LCX and RCA were less in group I than group II (21.9% vs 34.3%, and 43.8% vs 78.1%, respectively). Diffuse LAD and RCA lesions were more in group II (36.4% vs 52.4% and 42.9% vs 48.0%, respectively), but diffuse LCX lesion was more in group I (42.9 vs 36.4%). Multiple irregular lesions are more common in older age group (53.1%) than younger age group (28.1%). Conclusion: The younger age group has less favorable lipid profile than older age group having raised total cholesterol, decreased HDL and raised LDL. CAG findings show that most of the lesions are present in LAD (having less impressive LVEF) as like as in older age group, but older age group has more multiple irregular lesions. Prevalence of >2 lesions in one coronary artery was more in group I (31 vs. 25%) but difference was not statistically significant. Keywords: Lipid profile, Coronary angiogram, Younger patients, Acute Coronary Syndrome. DOI: http://dx.doi.org/10.3329/cardio.v1i2.8237 Cardiovasc. j. 2009; 1(2): 183-188

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Paratesticular Adipocytic Neoplasms Evaluated at a Single Institution

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz113.090 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S73-S74

Author(s):

Mohamed Mustafa ◽

David Priemer ◽

Muhammad Idrees ◽

Shaoxiong Chen

Keyword(s):

Spermatic Cord ◽

Older Age ◽

Age Group ◽

Single Institution ◽

Complex Anatomy ◽

Younger Age ◽

Mean Size ◽

Cord Lipoma ◽

The Mean ◽

Well Differentiated

Abstract Objectives Some of the scrotal masses are extratesticular neoplasias and develop from paratesticular tissues. Paratesticular region has a complex anatomy and contains epididymal and testicular appendages as spermatic cord, testicular tunicas, epididymis, and vestigial remnants. Therefore, neoplasms originating from this region comprise a heterogeneous group of tumors. Herein, we document paratesticular adipocytic neoplasms and the patient’s mean age and the mean size of tumor at presentation. Methods We retrospectively searched our database for paratesticular adipocytic neoplasms from the year 2001 to 2015. A total of 47 cases were identified and reports were reviewed. Results Of the total 47 cases, 28 (60%) spermatic cord lipomas, 9 (19%) well-differentiated liposarcomas, and 10 (21%) dedifferentiated liposarcomas were identified. The mean age for presentation for these diseases was of 41, 59, and 68 years, respectively. Conclusion The most common paratesticular adipocytic neoplasm in our institution is spermatic cord lipoma (60%), occurring in younger age group (mean age 40 years). However, up to 40% cases are malignant and include well-differentiated and dedifferentiated liposarcoma, occurring at a relatively older age population (59 and 68, respectively).

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Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions

Neurosurgical FOCUS ◽

10.3171/foc/2008/24/2/e16 ◽

2008 ◽

Vol 24 (2) ◽

pp. E16 ◽

Cited By ~ 80

Author(s):

Anand Veeravagu ◽

Raphael Guzman ◽

Chirag G. Patil ◽

Lewis C. Hou ◽

Marco Lee ◽

...

Keyword(s):

Clinical Outcomes ◽

Moyamoya Disease ◽

Pediatric Patients ◽

Pediatric Population ◽

Small Populations ◽

Age Group ◽

Radiological Findings ◽

Advantages And Disadvantages ◽

Pediatric Age Group ◽

Revascularization Procedures

✓Neurosurgical interventions for moyamoya disease (MMD) in pediatric patients include direct, indirect, and combined revascularization procedures. Each technique has shown efficacy in the treatment of pediatric MMD; however, no single study has demonstrated the superiority of one technique over another. In this review, the authors explore the various studies focused on the use of these techniques for MMD in the pediatric population. They summarize the results of each study to clearly depict the clinical outcomes achieved at each institution that had utilized direct, indirect, or combined techniques. In certain studies, multiple techniques were used, and the clinical or radiological outcomes were compared accordingly. Direct techniques have been shown to aid a reduction in perioperative strokes and provide immediate revascularization to ischemic areas; however, these procedures are technically challenging, and not all pediatric patients are appropriate candidates. Indirect techniques have also shown efficacy in the pediatric population but may require a longer period for revascularization to occur and perfusion deficits to be reversed. The authors concluded that the clinical efficacy of one technique over another is still unclear, as most studies have had small populations and the same outcome measures have not been applied. Authors who compared direct and indirect techniques noted approximately equal clinical outcomes with differences in radiological findings. Additional, larger studies are needed to determine the advantages and disadvantages of the different techniques for the pediatric age group.

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Covid-19 Incidence and Mortality by Age Strata and Comorbidities in Mexico City: A Focus in the Pediatric Population

Frontiers in Public Health ◽

10.3389/fpubh.2021.738423 ◽

2021 ◽

Vol 9 ◽

Author(s):

Nadia González-García ◽

María F. Castilla-Peón ◽

Fortino Solórzano Santos ◽

Rodolfo Norberto Jiménez-Juárez ◽

Maria Elena Martínez Bustamante ◽

...

Keyword(s):

Pediatric Population ◽

Age Groups ◽

Population Data ◽

Older Age ◽

Age Group ◽

Education Policies ◽

Infected People ◽

Risk Of Death ◽

Incidence And Mortality ◽

Pediatric Populations

Background: SARS-COV2 appears less frequently and less severely in the pediatric population than in the older age groups. There is a need to precisely estimate the specific risks for each age group to design health and education policies suitable for each population.Objective: This study aimed to describe the risk of death in SARS-COV2 infected subjects by age group and according to the presence of comorbidities.Methods: We analyzed data of confirmed SARS-COV2 infection cases where symptoms began between February 22th, 2020, and April 18th, 2021, as published by the General Epidemiology Direction (DGE) of the Mexican Ministry of Health. We calculated COVID-19 incidence and mortality by age group using population data from the Statistics and Population National Institute (INEGI), and estimated the association between risk of death and the presence of comorbidities.Results: Mortality in SARS-COV2 infected people varied considerably, between 7 and 155 deaths per million per year in the under-20 age groups compared to 441 to 15,929 in the older age groups. Mortality in pediatric populations is strongly associated with comorbidities (OR: 4.6-47.9) compared to the milder association for older age groups (OR: 3.16–1.23).Conclusion: The risk of death from SARS-COV2 infection in children is low and is strongly associated with comorbidities.

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