COVID-19-associated deaths were reported in the United States (1). Understanding the demographic and clinical characteristics of decedents could inform medical and public health interventions focused on preventing COVID-19-associated mortality. This report describes decedents with laboratory-confirmed infection with SARS-CoV-2, the virus that causes COVID-19, using data from 1) the standardized CDC case-report form (case-based surveillance) (https://www.cdc.gov/coronavirus/2019-ncov/php/ reporting-pui.html) and 2) supplementary data (supplemental surveillance), such as underlying medical conditions and location of death, obtained through collaboration between CDC and 16 public health jurisdictions (15 states and New York City). Case-based surveillanceDemographic and clinical data about COVID-19 cases are reported to CDC from 50 states, the District of Columbia, New York City, and U.S. territories using a standardized case-report form (case-based surveillance) or in aggregate. Data on 52,166 deaths from 47 jurisdictions among persons with laboratoryconfirmed COVID-19 were reported individually to CDC via case-based surveillance during February 12-May 18, 2020. Among the 52,166 decedents, 55.4% were male, 79.6% were aged ≥65 years, 13.8% were Hispanic/Latino (Hispanic), 21.0% were black, 40.3% were white, 3.9% were Asian, 0.3% were American Indian/Alaska Native (AI/AN), 0.1% were Native Hawaiian or other Pacific Islander (NHPI), 2.6% were multiracial or other race, and race/ethnicity was unknown for 18.0%. (Table 1). Median decedent age was 78 years (interquartile range (IQR) = 67-87 years). Because information about underlying medical conditions was missing for the majority of these decedents (30,725; 58.9%), data regarding medical conditions were not analyzed further using the case-based surveillance data set. Because most decedents reported to the supplementary data program were also reported to case-based surveillance, no statistical comparisons of the decedent characteristics between the data sets were made. * Underlying medical conditions include cardiovascular disease (congenital heart disease, coronary artery disease, congestive heart failure, hypertension, cerebrovascular accident/stroke, valvular heart disease, conduction disorders or dysrhythmias, other cardiovascular disease); diabetes mellitus; chronic lung disease (chronic obstructive pulmonary disease/emphysema, asthma, tuberculosis, other chronic lung diseases); immunosuppression (cancer, human immunodeficiency virus (HIV) infection, identified as being immunosuppressed); chronic kidney disease (chronic kidney disease, end-stage renal disease, other kidney diseases); neurologic conditions (dementia, seizure disorder, other neurologic conditions); chronic liver disease (cirrhosis, alcoholic hepatitis, chronic liver disease, end-stage liver disease, hepatitis B, hepatitis C, nonalcoholic steatohepatitis, other chronic liver diseases); obesity (body mass index ≥30 kg/m 2 ). Information was collected from decedent medical records or death certificates. ...
, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Although non-Hispanic American Indian and Alaska Native (AI/AN) persons account for 0.7% of the U.S. population,* a recent analysis reported that 1.3% of coronavirus disease 2019 (COVID-19) cases reported to CDC with known race and ethnicity were among AI/AN persons (1). To assess the impact of COVID-19 among the AI/AN population, reports of laboratory-confirmed COVID-19 cases during January 22 †-July 3, 2020 were analyzed. The analysis was limited to 23 states § with >70% complete race/ethnicity information and five or more laboratory-confirmed COVID-19 cases among both AI/AN persons (alone or in combination with other races and ethnicities) and non-Hispanic white (white) persons. Among 424,899 COVID-19 cases reported by these states, 340,059 (80%) had complete race/ethnicity information; among these 340,059 cases, 9,072 (2.7%) occurred among AI/AN persons, and 138,960 (40.9%) among white persons. Among 340,059 cases with complete patient race/ethnicity data, the cumulative incidence among AI/AN persons in these 23 states was 594 per 100,000 AI/AN population (95% confidence interval [CI] = 203-1,740), compared with 169 per 100,000 white population (95% CI = 137-209) (rate ratio [RR] = 3.5; 95% CI = 1.2-10.1). AI/AN persons with COVID-19 were younger (median age = 40 years; interquartile range [IQR] = 26-56 years) than were white persons (median age = 51 years; IQR = 32-67 years). More complete case report data and timely, culturally responsive, and evidencebased public health efforts that leverage the strengths of AI/AN communities are needed to decrease COVID-19 transmission and improve patient outcomes.
, approximately 6.5 million cases of SARS-CoV-2 infection, the cause of coronavirus disease 2019 (COVID-19), and 190,000 SARS-CoV-2-associated deaths have been reported in the United States (1,2). Symptoms associated with SARS-CoV-2 infection are milder in children compared with adults (3). Persons aged <21 years constitute 26% of the U.S. population (4), and this report describes characteristics of U.S. persons in that population who died in association with SARS-CoV-2 infection, as reported by public health jurisdictions. Among 121 SARS-CoV-2-associated deaths reported to CDC among persons aged <21 years in the United States during February 12-July 31, 2020, 63% occurred in males, 10% of decedents were aged <1 year, 20% were aged 1-9 years, 70% were aged 10-20 years, 45% were Hispanic persons, 29% were non-Hispanic Black (Black) persons, and 4% were non-Hispanic American Indian or Alaska Native (AI/AN) persons. Among these 121 decedents, 91 (75%) had an underlying medical condition,* 79 (65%) died after admission to a hospital, and 39 (32%) died at home or in the emergency department (ED). † These data show that nearly three quarters of SARS-CoV-2-associated deaths among infants, children, adolescents, and young adults have occurred in persons aged 10-20 years, with a disproportionate percentage among young adults aged 18-20 years and among Hispanics, Blacks, AI/ANs, and persons with underlying medical conditions. Careful monitoring of SARS-CoV-2 * https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/peoplewith-medical-conditions.html. † Location of death for all cases (121): hospital (79 [65.3%]), home (16 [13.2%]), ED (23 [19.0%]), hospice (one [0.8%]), and unknown (2 [1.7%]).
This is a prepublication version of an article that has undergone peer review and been accepted for publication but is not the final version of record. This paper may be cited using the DOI and date of access. This paper may contain information that has errors in facts, figures, and statements, and will be corrected in the final published version. The journal is providing an early version of this article to expedite access to this information. The American Academy of Pediatrics, the editors, and authors are not responsible for inaccurate information and data described in this version.
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