Letter to the Editor: Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden

“We followed all children who were admitted to an ICU between March 1 and June 30, 2020 (school ended around June 10) with laboratory-verified or clinically verified Covid-19, including patients who were admitted for multisystem inflammatory syndrome in children (MIS-C, which is likely to be related to Covid-19) according to the Swedish Pediatric Rheumatology Quality Register… The Stockholm Ethics Review Board approved the study.

The number of deaths from any cause among the 1,951,905 children in Sweden (as of December 31, 2019) who were 1 to 16 years of age was 65 during the pre–Covid-19 period of November 2019 through February 2020 and 69 during 4 months of exposure to Covid-19 (March through June 2020) (see the Supplementary Appendix). From March through June 2020, a total of 15 children with Covid-19 (including those with MIS-C) were admitted to an ICU (0.77 per 100,000 children in this age group) (Table 1), 4 of whom were 1 to 6 years of age (0.54 per 100,000) and 11 of whom were 7 to 16 years of age (0.90 per 100,000). Four of the children had an underlying chronic coexisting condition (cancer in 2, chronic kidney disease in 1, and hematologic disease in 1). No child with Covid-19 died [emphasis added]…

Despite Sweden’s having kept schools and preschools open, we found a low incidence of severe Covid-19 among schoolchildren and children of preschool age during the SARS-CoV-2 pandemic. Among the 1.95 million children who were 1 to 16 years of age, 15 children had Covid-19, MIS-C, or both conditions and were admitted to an ICU, which is equal to 1 child in 130,000 [emphasis added].”