At least 5.2 million children in the world have lost a parent, grandparent, or family member who helped care for them through the coronavirus, a new study revealed.

The study, published Thursday in the medical journal, The Lancet Child & Adolescent Health, examines the coronavirus mortality data from 21 countries from the start of the pandemic in March 2020 through Oct. 2021 and estimates the number of children who lost a parent or caregiver. The study says the number of children affected by a loss rose by 90% from the end of April 2020 to the end of October 2021.

The authors—including researchers from the U.S. Centers for Disease Control and Prevention, USAID, the World Bank, and the University College London—think the estimate may be an undercount. CNN reported many countries lack an accountable system for recording deaths, including many on the African continent.

The study reveals of the children examined, three out of four lost fathers. Preteens and teenagers were the most likely to be orphaned with two out of three children that lost a parent being adolescents.

Additionally, CNN reported earlier studies show U.S. communities of color were disproportionately affected by parental deaths. The authors say public health leaders must pay attention to the needs of children because when a parent dies, youth are vulnerable to gangs, sexual violence, and exploitation.

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