International heterogeneity in coronavirus disease 2019 pediatric mortality rates
International heterogeneity in coronavirus disease 2019 pediatric mortality rates
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DOI：
10.24875/bmhim.20000291
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发表时间：
2021-02-01
期刊：
影响因子：
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通讯作者：
Castilla-Peón, Ma. Fernanda
中科院分区：
文献类型：
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作者：
González-García, Nadia;Miranda-Lora, América L.;Castilla-Peón, Ma. Fernanda
背景：2019年严重冠状病毒病（COVID-19）在儿童中罕见，死亡率约为0.08%。本研究旨在探讨儿童死亡率的国际差异。方法：我们分析了几个人口超过500万的国家，这些国家报告了按五岁或十岁年龄组分列的COVID-19死亡数据。数据从年龄数据库、国家卫生部和世界卫生组织的COVID-19病例和死亡中提取。结果：我们纳入了23个国家的分析。儿童死亡率在相应年龄组的每百万儿童中从0到12.1不等，秘鲁的死亡率最高。除巴西外，在大多数国家，0至4岁年龄组的死亡更为常见。小儿/普通COVID-19死亡率差异很大，从0%（大韩民国）到10.4%（印度）不等。儿科和儿科/普通人群的COVID-19死亡率与2018年新生儿死亡率密切相关（r = 0.77, p < 0.001; r = 0.88, p < 0.001），而与普通人群的COVID-19死亡率中度或无相关性（r = 0.47, p = 0.02; r = 0.19, p = 0.38）。结论：儿童COVID-19死亡率的国际异质性与历史新生儿死亡率具有重要的相似性。新生儿死亡率是衡量一个国家卫生系统质量的一个众所周知的指标，它表明健康的社会决定因素在儿童COVID-19死亡率差异中的重要性。这个问题应该进一步探讨。
Background: Severe coronavirus disease 2019 (COVID-19) is infrequent in children and shows a mortality rate of around 0.08%. This study aims to explore international differences in the pediatric mortality rate. Methods: We analyzed several countries with populations over 5 million that report disaggregated data of COVID-19 deaths by quinquennial or decennial age groups. Data were extracted from COVID-19 cases and deaths by age database, National Ministeries of Health, and the World Health Organization. Results: We included 23 countries in the analysis. Pediatric mortality varied from 0 to 12.1 deaths per million children of the corresponding age group, with the highest rate in Peru. In most countries, deaths were more frequent in the 0- 4-year-old age group, except for Brazil. The pediatric/general COVID-19 mortality showed a great variation and ranged from 0% (Republic of Korea) to 10.4% (India). Pediatric and pediatric/general COVID mortality correlates strongly with 2018 neonatal mortality (r = 0.77, p < 0.001; and r = 0.88, p < 0.001, respectively), while shows a moderate or no correlation (r = 0.47, p = 0.02; and r = 0.19, p = 0.38, respectively) with COVID-19 mortality in the general population. Conclusions: International heterogeneity in pediatric COVID-19 mortality importantly parallels historical neonatal mortality. Neonatal mortality is a well-known index of the quality of a country's health system, which points to the importance of social determinants of health in pediatric COVID-19 mortality disparities. This issue should be further explored.