Projected US Pediatric COVID-19 Numbers Could Overextend Resources

May 4, 2020

The study warned that, with 74 million children in the United States, PICU resources could face concerning strain from COVID-19.

A recent study published in Public Health Management & Practice found that, based on projected numbers of severe pediatric cases of coronavirus disease 2019 (COVID-19) in the United States, a surge in pediatric COVID-19 cases would result in “unique challenges” and possible resource strain for pediatric intensive care units (PICUs).1

The empirical case projection study calculated estimated rates of children infected with COVID-19 in the United States, in addition to projected cumulative numbers of children severely ill with the virus and needing to be hospitalized.1

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has infected more than 1,094,000 Americans, and over 3,329,000 worldwide.2

Seventy-four children were reportedly admitted to PICUs in 19 states by April 6. According to the study, this rate reflects approximately 176,190 children in total infected with the virus (52,381 infants and toddlers younger than 2; 42, 859 children ages 2 to 11; and 80,952 children between the ages of 12 and 17).

Proportions for adjusted pediatric severity and adjusted pediatric criticality came from clinical and spatiotemporal modeling studies of SARS-CoV-2 when it spread through China between January and February 2020.1

Estimates of total COVID-19 pediatric infections in the United States were determined by US pediatric intensive care unit (PICU) cases and the adjusted pediatric criticality proportion. Investigators created the projected numbers of severely and critically ill children through the application of adjusted severity and criticality proportions to population data in the United States, under various scenarios and combined pediatric infection proportion (CPIP).

Applying a CPIP scenario of 5% would result in an estimated 3.7 million pediatric infections, 2997 children severely ill and needing to be hospitalized, and 1086 pediatric patients critically ill and needing treatment at a PICU.1

Even in moderate CPIP scenarios, the number of pediatric cases could overextend PICU resources, according to the study.1


1. EB Pathak, JP Salemi, N Sobers, et al. COVID-19 in Children in the United States. Journal of Public Health Management and Practice. 2020; doi: 10.1097/PHH.0000000000001190.
2. Coronavirus Resource Center. Johns Hopkins University & Medicine. Accessed May 1, 2020.