Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is rarely fatal in children and young people (CYP, <18 years old), but quantifying the risk of death is challenging because CYP are often infected with SARS-CoV-2 exhibiting no or minimal symptoms. To distinguish between CYP who died as a result of SARS-CoV-2 infection and those who died of another cause but were coincidentally infected with the virus, we undertook a clinical review of all CYP deaths with a positive SARS-CoV-2 test from March 2020 to February 2021. The predominant SARS-CoV-2 variants were wild-type and Alpha. Here we show that, of 12,023,568 CYP living in England, 3,105 died, including 61 who were positive for SARS-CoV-2. Of these deaths, 25 were due to SARS-CoV-2 infection (mortality rate, two per million), including 22 due to coronavirus disease 2019—the clinical disease associated with SARS-CoV-2 infection—and 3 were due to pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. In total, 99.995% of CYP with a positive SARS-CoV-2 test survived. CYP older than 10 years, Asian and Black ethnic backgrounds and comorbidities were over-represented in SARS-CoV-2-related deaths compared with other CYP deaths. These results are important for guiding decisions on shielding and vaccinating children. New variants might have different mortality risks and should be evaluated in a similar way.

严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染在儿童和年轻人（CYP，<18 岁）中很少致命，但量化死亡风险具有挑战性，因为 CYP 经常感染 SARS-CoV-2无症状或症状轻微。为了区分死于 SARS-CoV-2 感染的 CYP 和死于其他原因但巧合感染该病毒的 CYP，我们对来自 SARS-CoV-2 检测呈阳性的所有 CYP 死亡进行了临床审查。 2020 年 3 月至 2021 年 2 月。主要的 SARS-CoV-2 变体是野生型和 Alpha。在这里，我们显示，在居住在英格兰的 12,023,568 名 CYP 中，有 3,105 人死亡，其中 61 人对 SARS-CoV-2 呈阳性。在这些死亡中，有 25 人是由于 SARS-CoV-2 感染（死亡率，百万分之二），其中 22 例是由于 2019 年冠状病毒病（与 SARS-CoV-2 感染相关的临床疾病）和 3 例是由于与 SARS-CoV-2 暂时相关的小儿炎症性多系统综合征。总体而言，99.995% 的 SARS-CoV-2 检测呈阳性的 CYP 存活。与其他 CYP 死亡相比，10 岁以上的 CYP、亚洲和黑人种族背景和合并症在 SARS-CoV-2 相关死亡中的比例过高。这些结果对于指导儿童的防护和疫苗接种决策非常重要。新变体可能具有不同的死亡风险，应该以类似的方式进行评估。与其他 CYP 死亡相比，亚洲和黑人种族背景和合并症在 SARS-CoV-2 相关死亡中的比例过高。这些结果对于指导儿童的防护和疫苗接种决策非常重要。新变体可能具有不同的死亡风险，应该以类似的方式进行评估。与其他 CYP 死亡相比，亚洲和黑人种族背景和合并症在 SARS-CoV-2 相关死亡中的比例过高。这些结果对于指导儿童的防护和疫苗接种决策非常重要。新变体可能具有不同的死亡风险，应该以类似的方式进行评估。