The recently published “Deaths in children and young people in England after SARS-CoV-2 infection during the first pandemic year”¹ attempts to unpick the issue of paediatric deaths “with” versus “from” COVID-19, additionally reporting on pre-existing comorbidities of the children and young people (CYP) who died after a COVID-19 diagnosis. Linking data from the National Child Mortality Database (NCMD), hospital data from the Secondary Uses Service (SUS), and PICU audit data, the authors have re-examined deaths in CYP after a COVID-19 diagnosis using these datasets. However, whilst data on any pre-existing conditions may be useful to identify the children at highest risk from COVID-19, we have some concerns around the methodology and presentation of the first part of this study.