This study estimates the number of children that will be infected with SARS-CoV-2 and the cumulative numbers of severely ill pediatric COVID-19 cases requiring hospitalization during the US 2020 pandemic.

The authors derived adjusted pediatric severity proportions and adjusted pediatric criticality proportions from clinical and spatiotemporal modelling studies of the COVID-19 epidemic in China for the period Jan-Feb 2020. They calculated estimates of total children infected with SARS-CoV-2 in the US through April 6, 2020 using US pediatric intensive care unit (PICU) cases and the adjusted pediatric criticality proportion. They derived projected numbers of severely and critically ill children with COVID-19 by applying the adjusted severity and criticality proportions to US population data, under several scenarios of cumulative pediatric infection proportion (CPIP).

By April 6, 2020, there were 74 children who had been reported admitted to PICUs in 19 states, reflecting an estimated 176,190 children nationwide infected with SARS-CoV-2 (52,381 infants and toddlers <2 years, 42,857 children 2-11 years, and 80,952 children 12-17 years).

Under a CPIP scenario of 5%, the authors estimate that there will be 3.7 million children infected with SARS-CoV-2: 9,907 severely ill children requiring hospitalization and 1,086 critically ill children requiring PICU admission.

Under a CPIP scenario of 50%, they estimate that there will be 10,865 children requiring  PICU admission, 99,073 requiring hospitalization for severe pneumonia, and 37.0 million children infected.

In summary, because there are 74.0 million children 0-17 years old in the US, the number of severe cases projected from these models could overwhelm available pediatric hospital care resources, despite lower severity of COVID-19 in children than in adults.