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US reports show racial disparities in kids with COVID-19

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NEW YORK (AP) — Racial disparities in the U.S. coronavirus epidemic extend to children, according to two sobering government reports released Friday.

One of the Centers for Disease Control and Prevention reports looked at children with COVID-19 who needed hospitalization. Hispanic children were hospitalized at a rate eight times higher than white kids, and Black children were hospitalized at a rate five times higher, it found.

The second report examined cases of a rare virus-associated syndrome in kids. It found that nearly three-quarters of the children with the syndrome were either Hispanic or Black, well above their representation in the general population.

The coronavirus has exposed racial fractures in the U.S. health care system, as Black, Hispanic and Native Americans have been hospitalized and killed by COVID-19 at far higher rates than other groups.

Meanwhile, the impact of the virus on children has become a political issue. President Donald Trump and some other administration officials have been pushing schools to re-open, a step that would allow more parents to return to work and the economy to pick up.

On Wednesday, Facebook deleted a post by Trump for violating its policy against spreading misinformation about the coronavirus. The post featured a link to a Fox News video in which Trump says children are “virtually immune” to the virus.

The vast majority of coronavirus cases and deaths have been in adults, and kids are considered less likely to have serious symptoms when they’re infected. Of the nearly 5 million cases reported in the U.S. as of Wednesday, about 265,000 were in children 17 and under — about 5%. Of the more than 156,000 deaths reported at that time, 77 were children — about 0.05%.

But Friday’s CDC reports are a “gut punch” reminder that some children are getting seriously ill and dying, said Carrie Henning-Smith, a University of Minnesota researcher who focuses on health disparities....

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...n April 2020, during the peak of the coronavirus disease 2019 (COVID-19) pandemic in Europe, a cluster of children with hyperinflammatory shock with features similar to Kawasaki disease and toxic shock syndrome was reported in England* (1). The patients’ signs and symptoms were temporally associated with COVID-19 but presumed to have developed 2–4 weeks after acute COVID-19; all children had serologic evidence of infection with SARS-CoV-2, the virus that causes COVID-19 (1).

The clinical signs and symptoms present in this first cluster included fever, rash, conjunctivitis, peripheral edema, gastrointestinal symptoms, shock, and elevated markers of inflammation and cardiac damage (1). On May 14, 2020, CDC published an online Health Advisory that summarized the manifestations of reported multisystem inflammatory syndrome in children (MIS-C), outlined a case definition, and asked clinicians to report suspected U.S. cases to local and state health departments. As of July 29, a total of 570 U.S. MIS-C patients who met the case definition had been reported to CDC. A total of 203 (35.6%) of the patients had a clinical course consistent with previously published MIS-C reports, characterized predominantly by shock, cardiac dysfunction, abdominal pain, and markedly elevated inflammatory markers, and almost all had positive SARS-CoV-2 test results. The remaining 367 (64.4%) of MIS-C patients had manifestations that appeared to overlap with acute COVID-19 (24), had a less severe clinical course, or had features of Kawasaki disease...

The median patient age was 8 years (range = 2 weeks–20 years); 55.4% were male, 40.5% were Hispanic or Latino (Hispanic), 33.1% were non-Hispanic black (black), and 13.2% non-Hispanic white (white) (Table 1). Obesity was the most commonly reported underlying medical condition, occurring in 30.5% of Hispanic, 27.5% of black, and 6.6% of white MIS-C patients....

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