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L.A. County teen’s death may be coronavirus-related. Here’s what we know

A playground cordoned off with caution tape
Children’s playground equipment is cordoned off at Venice Beach on Monday.
(Al Seib / Los Angeles Times)

A teenager who lived in Lancaster may be the first child to have died from the coronavirus, but confirming that will require additional testing, authorities said.

Los Angeles County health officials announced Tuesday what they believed to be the first COVID-19 death in the U.S. of someone younger than 18.

Experts have long said older people are more susceptible to the virus and that young people in general are less likely to contract the illness. But health officials said Tuesday the death underscores the threat that coronavirus poses to the entire population.

“This is a devastating reminder that COVID-19 affects people of all ages,” L.A. County Public Health Department Director Barbara Ferrer said.

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But a few hours after that announcement, the county’s Public Health Department sent out a clarification:

“The juvenile fatality that the Los Angeles County Department Public Health reported earlier today will require further evaluation by the Centers for Disease Control and Prevention,” the statement read. “Though early tests indicated a positive result for COVID-19, the case is complex and there may be an alternate explanation for this fatality. Patient privacy prevents our offering further details at this time.”

The minor was a teenager who lived in Lancaster and did not have any preexisting conditions, Los Angeles Mayor Eric Garcetti said in a news briefing Tuesday evening.

The Public Health Department was working to confirm how the teenager might have contracted the virus. The agency also is also working to confirm whether the case marks the first such death of a minor linked to coronavirus in the country, but cases are not always broken down by age, said Tim Gilman, a representative for the department.

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The death toll in Los Angeles County now stands at 11.

The latest maps and charts on the spread of COVID-19 in California.

According to a Centers for Disease Control and Prevention report released last week, there had been no coronavirus fatalities in the United States of people under 18. The report also said there had been no reported ICU admissions for people under 19.

Age breakdowns

Overall, relatively few young people have tested positive in Los Angeles County. But the data show people between the ages of 18 and 65 have tested positive most often. (These numbers exclude Pasadena and Long Beach.):

0-17: 10
18-40: 268
41-65: 250
65+: 107

In Orange County, the numbers are similar:

0-17: 1
18-49: 87
50-64: 41
65+ 23

Here are the statewide age breakdowns, as of Monday:

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0-17: 25
18-49: 837
50-64: 442
65+: 415
Unknown age: 14

Child risks

Overall, officials have said young children are at lesser risk than older people for contracting the coronavirus.

One possible reason babies, toddlers and young children have not been critically threatened is because of their immature immune systems. An undeveloped immune system might prevent the body from triggering inflammation severe enough to result in pneumonia, septic shock or organ failure.

A sweeping review of 44,672 lab-confirmed COVID-19 patients in China published in early March by Chinese authorities found that no deaths occurred among anyone younger than 10.

Another study by experts in Wuhan, China — the initial epicenter of the outbreak — published in the Journal of the American Medical Assn. sought to review all hospitalized infants diagnosed with COVID-19 infection between Dec. 8 and Feb. 6 in China.

By Feb. 6, there had been 31,211 confirmed cases of COVID-19 and 637 fatalities. But the authors could find only nine infected babies who were hospitalized nationwide.

“None of the nine infants required intensive care or mechanical ventilation or had any severe complications,” the study said.

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Four had fever, two had mild upper respiratory tract symptoms, and one had no symptoms but tested positive for the virus because of the baby’s exposure to an infected family member. There were no symptoms available for the other two patients.

And a report published in the World Journal of Pediatrics, summarizing experts’ consensus on the coronavirus in children, also warned that people who have a “silent infection” are among the main sources of transmission for the illness.

“We also should attach importance to asymptomatic cases, which may play a critical role in the transmission process,” the report said. “Respiratory droplets and contact are the main transmission routes. Close contact with symptomatic cases and asymptomatic cases with silent infection are the main transmission routes of [novel coronavirus] infection in children.”

And while children are largely spared the worst effects of the coronavirus, the first reports to document COVID-19 deaths in children make clear that those under 18 are neither immune from infection nor completely spared from becoming very sick.

In China, the novel coronavirus has claimed the lives of a 10-month-old and a 14-year-old, at least.

Possible correlation

As officials try to determine the exact cause of death for the teenager, it’s possible the coronavirus and bacterial infection are correlated.

“We do know that respiratory viruses in general can exacerbate secondary bacterial infections,” said Dr. Yvonne Maldonado, a Stanford University professor of pediatric infectious diseases and the chair of the American Pediatrics Committee on Infectious Diseases.

Maldonado said it’s possible that a viral infection could worsen a bacterial superinfection and lead to a secondary bacterial infection, including pneumonia or sepsis.

“I see no reason why this virus would be any different,” she said.

Times staff writers Luke Money and Melissa Healy contributed to this report.


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