New statistics show number of children admitted into intensive care with COVID-19

New figures released today by the Universities of Leeds and Leicester reveal the number of children in the UK who were in paediatric intensive care units with COVID-19.

Compiled by the Paediatric Intensive Care Audit Network (PICANet) for the period between 15 March and 13 June 2020, the figures provide the first UK-wide picture of how many children were severely ill with coronavirus, their ethnic and patient characteristics, and mortalities.

PICANet were asked to carry out daily monitoring of all children testing positive for COVID-19 on paediatric intensive care units (PICUs), in the NHS and independent hospitals.

The key findings include:

• 71 children were admitted to a PICU, who tested positive for the virus either prior to being admitted or during their stay;
• Five mortalities were recorded;
• Three children remained in intensive care;
• 63 children were discharged to an alternative intensive care facility, another hospital ward or went home;
• The median age of the children was nine years old, with the inter-quartile range stretching from one year to 13 years;
• Almost two-thirds of the children were male (61%);
• Admissions peaked during the week beginning 6 April.

Peter Davis, Chair of the PICANet Clinical Advisory Group and Paediatric Intensivist at Bristol Children’s Hospital said: “Fortunately, severe COVID-19 infection in children is relatively rare, with only a small number of those children having tested positive for the SARS-Co-V-2 virus needing intensive care support.

“Outside of London, the numbers of children affected were extremely low, with some Paediatric Intensive Care Units not caring for any COVID-19 positive children so far during this pandemic, while the timing of COVID-19 positive PICU admissions closely follows that of adult ICU admissions, with a peak in early April, followed by a steady fall in cases. 

“Less than two-thirds of children testing positive and admitted to PICU needed invasive ventilation and lengths of stay were generally of only a few days. Overall, only 5 deaths in Paediatric Intensive Care Units occurred in children with a positive test for the virus, although it is impossible to confirm at this stage if the death was directly attributable to COVID-19 infection or not.”

In regards to demographic characteristics, around one third of the children were white (30%), almost a quarter were of Asian heritage (23%) and 14% were black. Data on the ethnicity of 21% of the children was not available.

Whilst in intensive care, 60% of the children required the highest level of support with their breathing, invasive ventilation for a median of six days – the inter-quartile range was from three to 12 days. Over 90% of the children were admitted as medical emergencies.

Just under 60% of the children were admitted for infections or respiratory conditions

PICANet is a project run jointly by the Universities of Leeds and Leicester, the network collated data on children’s intensive care with the aim of identifying best clinical practice and facilitating healthcare planning.

Professor Liz Draper, co-principal investigator at PICANet and Professor of Paediatric and Perinatal Epidemiology at the University of Leicester said: “Given the geographical distribution of admissions, with the majority being cared for in London PICUs, and other units within major conurbations with large BAME populations, and the relatively small numbers of children affected, it is impossible to confirm whether or not certain ethnic groups of children are at greater risk of severe COVID-19 illness in the way that has been described in adults. 

“However, previously published PICANet studies covering a number of years before this pandemic, and including much larger numbers, had already shown South Asian children to be almost twice as likely as to be admitted to PICU as compared to children of non-South Asian ethnicity, and once admitted to PICU to be at greater risk of mortality.”

Response from Dr Richard Feltbower, co-principal investigator at PICANet and Senior Lecturer in Epidemiology at the University of Leeds: “The data shows the number of children who tested positive for covid-19 prior to being admitted into paediatric intensive care or while they were in an PICU. It is worth stressing that some might not have been in a PICU primarily because of covid-19: they may have had other health conditions.

“Future research investigate whether any of the children were experiencing a rare inflammatory disease linked to COVID-19 called paediatric multi system inflammatory syndrome.

“We will also look at any links between childhood obesity and an increased risk of suffering a severe form of COVID-19."