ArticleBMC pediatrics2025
Epidemic profile of COVID-19 child deaths in Sri Lanka: a retrospective nationwide analysis.
Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
introductionUnderstanding the impact of the COVID-19 pandemic on child survival is crucial. Analysing COVID-19-related child deaths, even years after the pandemic, is critical for informing future pandemic preparedness and response efforts.
methodsWe conducted an analysis of all "SARS-CoV-2/COVID-19 positive deaths" among children and adolescents (aged < 18 years) recorded through a purposefully designed Child Death Surveillance and Response System (CDSRS) from October 2020 to September 2022. It included all deaths with a positive SARS-CoV-2. The analysis involved a thorough review of documents (bedhead tickets, field/institutional investigation and postmortem examination reports, and compiled case scenarios). Multivariable backward logistic regression was conducted to identify risk factors associated with deaths attributed to COVID-19 infection. Additionally, a comparison of socio-demographic characteristics was conducted between deaths due to all causes and those attributed to COVID-19 infection.
resultsA total of 111 deaths with a positive SARS-CoV-2 test were analyzed. Among these, 81 deaths (73%) were categorized as directly attributed to COVID-19 infection. Fourteen children (17.2%) had Multisystem Inflammatory Syndrome. Cardiovascular disease was the most common comorbidity (28.4%). The odds of deaths attributed to COVID-19 infection were eleven times higher with chronic diseases compared to incidental SARS-CoV-2 positive test (OR:11.22, 95% CI:1.735, 72.496). Tamil ethnicity appeared to be protective when compared to the Sinhalese (OR:0.07, 95% CI: 0.008, 0.598). The model explained 44.8% of the variance. When compared to national all-cause mortality data, females (p = 0.03), post-neonatal infants (p < 0.001), and > 5-18 years (p = 0.005) were identified as being at higher risk of death due to COVID-19 infection.
conclusionThe proportion of COVID-19-positive deaths during the study period was higher than that reported in high-income countries, with most deaths directly attributed to SARS-CoV-2. Higher mortality rates were observed among post-neonatal infants, children over five years, females, those with Sinhalese ethnicity, and pre-existing chronic medical conditions, particularly cardiovascular disease.
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