Black and Hispanic children and adolescents, along with those with underlying medical conditions, make up the majority of Covid-19 deaths in patients younger than 21, according to a report published Tuesday from the Centers for Disease Control and Prevention.
The report looked at a total of 121 Covid-19 deaths in children and adolescents from Feb. 12 through July 31. Of these cases, 15 were confirmed to have MIS-C, an inflammatory condition linked to Covid-19.
The majority of deaths — 85 total — were in those ages 10 to 20, and patients 18 to 20 years old were particularly vulnerable. Similar to mortality in adults with Covid-19, young males were more likely to die.
Deaths among children younger than 10 were less common: There were 24 deaths in children ages 1 to 9, and 12 deaths in infants, the report said.
Dr. Rishi Desai, a pediatric infectious disease doctor and chief medical officer at Osmosis, a medical education company, said the age distribution of the deaths wasn't surprising.
People ages 18 to 20 are probably doing more risky activities, like going out to bars and parties, Desai said. "In general, their number of social contacts dramatically goes up."
"And when they do get [Covid-19], biologically, they're more predisposed to getting very sick with it," compared to younger children, said Desai, who was not involved with the new report but is a former infectious disease officer at the CDC.
Still, the findings don't mean that the very young are invulnerable; as the report shows, "we have seen kids die under the age of 10," Desai said.
Young people with at least one underlying condition were more likely to die, and nearly half of the deaths were in those with two or more underlying health conditions. Just a quarter of the deaths were in people who were considered previously healthy.
Asthma and obesity were the most commonly reported underlying conditions among young people who died. Both conditions are common: According to the CDC, obesity affects about 1 in 5 young people ages 2 to 19, and asthma affects 1 in 12 people who are 17 or younger.
The report found that Covid-19 deaths were disproportionate among racial and ethnic minorities, with Hispanic, Black and American Indian/Alaska Native patients accounting for 75 percent of the deaths among young people. Together, these groups make up just 41 percent of the U.S. population under age 21.
Desai said that while it wasn't surprising that young Hispanic and Black patients were more likely to die of Covid-19 than white patients, "what was slightly surprising was that it wasn't even close."
"The amount of difference was striking," he added.
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These racial and ethnic groups are also disproportionately represented among essential workers who were unable to work from home during the pandemic, putting them at higher risk of exposure to the virus, as well as the potential to pass it to family members, the authors wrote.
These are young people that are more likely to live in multigenerational families, Desai said. "They're more likely to have family members that are essential workers that can't not be out there."
On Monday, the American Academy of Pediatrics reported that there have been nearly 550,000 pediatric cases of Covid-19 in the United States since the start of the pandemic, including 105 deaths. That report only includes cases defined by the states as "pediatric" — an age that varies from state to state, and in some states, cuts off at 17. The latest CDC report included deaths reported in children and young people under age 21.