====== COVID-19 Risk Stratification ====== ===== Summary Risk Research ===== * [[https://collections.nlm.nih.gov/master/borndig/101774952/Risk%20Factors%20for%20COVID-19%20Mortality%20among%20Privately%20Insured%20Patients%20-%20A%20Claims%20Data%20Analysis%20-%20A%20FAIR%20Health%20White%20Paper.pdf|Nov 11, 2020]] Dr. [[:Marty Makary]]: Risk Factors for COVID-19 Mortality among Privately Insured Patients * 0.59% [[:Case Fatality Rate]] overall. * Sex: 60.07% Male * Age: 70+ was 4.82% of cases, but 42.43% of deaths * Cancer: 2.89 to 6.74 odds ratio for mortality. * Intellectual disabilities: 2.75 to 3.61 odds ratios. * Comorbidities: 83.29% had at least one comorbidity. * 0.01% CFR among 0-18. ===== Genetic Stratification ===== Protein expression lends itself to prediction of hospitalization and death from COVID-19 with high rates of accuracy.((October 19, 2021 | Science Daily | [[https://www.sciencedaily.com/releases/2021/10/211019082716.htm|Predicting patient death or hospitalization from COVID-19]])) ===== COVID-19 in Children ===== The topic of [[:COVID-19]] in children has become an artificial controversy during the [[:COVID-19 pandemic]], most likely due to the need to drive fear to encourage parents to offer up their children as medical experiments as part of the COVID-19 vaccine campaign. ==== Research Regarding COVID-19 in Children ==== * January 4, 2022: [[https://jamanetwork.com/journals/jamapediatrics/fullarticle/2787479 | Association of Birth During the COVID-19 Pandemic With Neurodevelopmental Status at 6 Months in Infants With and Without In Utero Exposure to Maternal SARS-CoV-2 Infection]]((Lauren C. Shuffrey, PhD; Morgan R. Firestein, PhD; Margaret H. Kyle, BA; et al )(2022) //JAMA Pediatr. Published online January 4, 2022. doi:10.1001/jamapediatrics.2021.5563//)) * August 1, 2021: [[https://publications.aap.org/hospitalpediatrics/article-abstract/11/8/e151/179740/For-COVID-or-With-COVID-Classification-of-SARS-CoV?redirectedFrom=fulltext|"For COVID" or "With COVID": Classification of SARS-CoV-2 Hospitalizations in Children.]]((Kushner, L. E., Schroeder, A. R., Kim, J., & Mathew, R. (2021). //“For COVID” or “With COVID”: Classification of SARS-CoV-2 Hospitalizations in Children.// Hospital Pediatrics, 11(8), e151–e156. https://doi.org/10.1542/hpeds.2021-006001)) * July 15, 2021: [[https://doi.org/10.1038/d41586-021-01897-w|Deaths from COVID ‘incredibly rare’ among children.]]((Ledford, H. (2021). //Deaths from COVID ‘incredibly rare’ among children.// Nature, 595(7869), 639. https://doi.org/10.1038/d41586-021-01897-w)) * April 2021: [[https://journals.lww.com/pidj/Fulltext/2021/04000/Risk_Factors_for_Severe_COVID_19_in_Children.2.aspx|Risk Factors for Severe COVID-19 in Children]]((Graff, K., Smith, C., Silveira, L., Jung, S., Curran-Hays, S., Jarjour, J., Carpenter, L., Pickard, K., Mattiucci, M., Fresia, J., McFarland, E. J., Dominguez, S. R., & Abuogi, L. (2021). //Risk Factors for Severe COVID-19 in Children.// The Pediatric Infectious Disease Journal, 40(4), e137. https://doi.org/10.1097/INF.0000000000003043)) * February 1, 2021: [[https://www.ijidonline.com/article/S1201-9712(20)32475-9/fulltext|Severe COVID-19 Infection and Pediatric Comorbidities: A Systematic Review and Meta-Analysis.]]((Kushner, L. E., Schroeder, A. R., Kim, J., & Mathew, R. (2021). //“For COVID” or “With COVID”: Classification of SARS-CoV-2 Hospitalizations in Children.// Hospital Pediatrics, 11(8), e151–e156. https://doi.org/10.1542/hpeds.2021-006001)) * January 1, 2021: [[https://publications.aap.org/pediatrics/article-abstract/147/1/e2020029736/33483/COVID-19-in-Children-Looking-Forward-Not-Back?redirectedFrom=fulltext|COVID-19 in Children: Looking Forward, Not Back.]]((Lee, B., & Raszka, W. V. (2020). //COVID-19 in Children: Looking Forward, Not Back.// Pediatrics, 147(1), e2020029736. https://doi.org/10.1542/peds.2020-029736)) * August 7, 2020: [[https://adc.bmj.com/content/106/7/709.info|Role of children in household transmission of COVID-19]]((Kim, J., Choe, Y. J., Lee, J., Park, Y. J., Park, O., Han, M. S., Kim, J.-H., & Choi, E. H. (2020). //Role of children in household transmission of COVID-19.// Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2020-319910 )) * December 31, 2021 Characteristics and Clinical Outcomes of Children and Adolescents Aged <18 Years Hospitalized with COVID-19 — Six Hospitals, United States, July–August 2021 [[https://www.cdc.gov/mmwr/volumes/70/wr/mm705152a3.htm?s_cid=mmmm705152a3_w]] === Pediatric Mortality Rates === * From March 2020 through February 2021 (one year), there were only 61 children in the UK who died where COVID-19 was listed as a contributing factor.((November 11, 2021 | Clare Smith et al | [[:Nature Medicine]] | [[https://www.nature.com/articles/s41591-021-01578-1|DOI https://doi.org/10.1038/s41591-021-01578-1]])) === Pediatric Hospitalization Rates === * COVID-19 and Children: ALL the Answers You Need in ONE PLACE((March 3, 2022 | [[:Justin Hart]] | [[https://covidreason.substack.com/p/covid-19-and-children-all-the-answers?s=r|COVID-19 and Children: ALL the Answers You Need in ONE PLACE]])) * The most important papers on SARS-COV2 in kids((March 3, 2022 | Josh Stevenson | [[https://relevantdata.substack.com/p/the-most-important-papers-on-sars?s=w|The most important papers on SARS-COV2 in kids]])) * Risk of Hospitalization, severe disease, and mortality due to COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany((November 30, 2021 | AL Sorg et al | Risk of Hospitalization, severe disease, and mortality due to COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany | [[https://www.medrxiv.org/content/10.1101/2021.11.30.21267048v1.full-text|doi: https://doi.org/10.1101/2021.11.30.21267048]])) === National Reports === == Germany == No children have died due to COVID-19. https://brownstone.org/articles/sweden-and-germany-no-deaths-in-children-due-to-covid/ == Iceland == No hospitalizations among children as of April 2020, and no evidence of children spreading to adults.((Thors, V. S. (2020, April). //EAP Blog – COVID-19 Series (#5) | Iceland’s data on the infectivity of children cross-infection risk.// European Academy of Paediatrics. https://www.eapaediatrics.eu/eap-blog-covid-19-series-5-icelands-data-on-the-infectivity-of-children-cross-infection-risk/)) == Netherlands == "Children become less seriously ill and almost never need to be hospitalised. Children who do end up in hospital are usually vulnerable as a result of another disease."((//Children, school and COVID-19.// (2021, December 14). National Institute for Public Health and the Environment. https://www.rivm.nl/en/coronavirus-covid-19/children-and-covid-19)) == Sweden == No children have died due to COVID-19. https://brownstone.org/articles/sweden-and-germany-no-deaths-in-children-due-to-covid/ ==== In the Media ==== On October 8, 2021, The New York Times retracted an article falsely claimed that over 900,000 children in the USA had been hospitalized due to COVID-19, overestimating the real number of 63,000 hospitalized children by a factor of 14.((The New York Times. (2021, October 8). //Corrections: Oct. 8, 2021.// Retrieved November 24, 2021, from https://www.nytimes.com/2021/10/08/pageoneplus/corrections-oct-8-2021.html)) ((Chaufan, C., MD PhD, Pelech, S., PhD, Collins, O., BSc, Forte, M., PhD, Francis, D., PhD, RN, Graham, J., PhD, de Ruiter, A., PhD, Rancourt, D., PhD, Rinner, C., PhD, Ponesse, J., PhD, Vrbik, J., PhD, Epstein-Gilboa, K., PhD, Durante, A., PhD, Springer, H., PhD, Hall, A. J., PhD, Zimmerman, J., PhD, Leduc, L., PhD, Cheung, K., PhD, Capurri, V., PhD, . . . Manwell, L., PhD. (2021, November 6). //Urgent Letter to Doug Ford: COVID-19 Vaccines Are Not Safe for Children and Youth.// Canadian Covid Care Alliance. Retrieved November 16, 2021, from https://www.canadiancovidcarealliance.org/wp-content/uploads/2021/11/Letter-to-Premier-Ford.ChildrenYouth21.11.06.pdf)) Even the lower number of 63,000 has been questioned, with some estimates of 39% to 48% of children originally admitted to hospital for unrelated illness but acquiring COVID-19 in the hospital.((Digitale, E. (2021, May 19). //COVID-19 hospitalizations among children likely overcounted, researchers find.// Stanford Medicine. Retrieved November 24, 2021, from http://med.stanford.edu/news/all-news/2021/05/covid-19-hospitalizations-among-kids-likely-overcounted.html)) On October 12, 2021, Alberta Chief Medical Officer of Health [[Deena Hinshaw]] reported "the death of a 14-year-old who had complex, pre-existing medical medical conditions that played a significant role in their death,” during a televised COVID-19 update.((CTV News Edmonton Staff. (2021, October 12). //“Our numbers are still extremely high”: Alberta reports 3,358 new COVID-19 cases, 33 deaths since Friday.// CTV News. https://edmonton.ctvnews.ca/our-numbers-are-still-extremely-high-alberta-reports-3-358-new-covid-19-cases-33-deaths-since-friday-1.5620555)) The family of the teenager in question publicly clarified that the young boy had actually died of end-stage cancer, and he simply tested "positive" for COVID-19 in the final days before his passing. After insisting [[Alberta Health Services]] was incorrect in their reporting, Hinshaw corrected her mistake and claimed they would evaluate co-morbidities in young COVID-19 deaths more carefully.((CTV News Edmonton Staff. (2021, October 14). //Hinshaw apologizes after Alberta mistakenly reports 14-year-old’s cancer death was caused by COVID-19.// CTV News. https://edmonton.ctvnews.ca/hinshaw-apologizes-after-alberta-mistakenly-reports-14-year-old-s-cancer-death-was-caused-by-covid-19-1.5623489)) ((Wallis Snowdon. (2021, October 15). //Alberta’s reporting of comorbidities questioned after boy, 14, removed from COVID-19 death count.// CBC. https://www.cbc.ca/news/canada/edmonton/covid-comorbidities-alberta-spitzer-1.6212510)) [[https://www.bbc.co.uk/news/uk-scotland-59347464 | At least 21 babies under four weeks old died in Scotland in September2021, a rate of 4.9 per 1,000 births (over double what would be expected)]].