tetano
Editor, Senior Moderator
J Pediatric Infect Dis Soc
. 2022 Aug 4;piac068.
doi: 10.1093/jpids/piac068. Online ahead of print.
Severity of Illness Caused by Severe Acute Respiratory Syndrome Coronavirus 2 Variants of Concern in Children: A Single-Center Retrospective Cohort Study
Priya R Edward[SUP] 1 [/SUP], Ramon Lorenzo-Redondo[SUP] 2 3 [/SUP], Megan E Reyna[SUP] 1 [/SUP], Lacy M Simons[SUP] 2 3 [/SUP], Judd F Hultquist[SUP] 2 3 [/SUP], Ami B Patel[SUP] 1 2 [/SUP], Egon A Ozer[SUP] 2 3 [/SUP], William J Muller[SUP] 1 2 [/SUP], Taylor Heald-Sargent[SUP] 1 2 [/SUP], Matthew McHugh[SUP] 1 [/SUP], Taylor Dean[SUP] 2 3 [/SUP], Raj M Dalal[SUP] 2 [/SUP], Jordan John[SUP] 2 [/SUP], Shannon C Manz[SUP] 2 [/SUP], Larry K Kociolek[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Recent COVID-19 surges are attributed to emergence of more transmissible SARS-CoV-2 variants of concern (VOCs). The relative severity of VOCs in children is unknown.
Methods: We performed a single-center retrospective cohort study of children ≤18 years old diagnosed with COVID-19 from October 2020-February 2022 and whose SARS-CoV-2 isolate underwent Illumina sequencing. We measured the frequency of five markers of COVID-19 severity. Logistic regression models were fitted to estimate the odds of each severity marker with each VOC.
Results: Among 714 children, 471 (66.0%) were infected with a VOC: 96 (13.4%) alpha, 38 (5.3%) gamma, 119 (16.7%) delta, and 215 (30.1%) omicron. High-risk medical conditions and increasing age were independently associated with COVID-19 severity. After adjusting for age, race, ethnicity, high-risk medical conditions, and COVID-19 community incidence, neither alpha, delta, nor omicron was associated with severe COVID-19. Gamma was independently associated with hospitalization (OR 6.7, 95% CI 2.0-22.1); pharmacologic treatment (OR 5.7, 95% CI 1.2-26.8); respiratory support (OR 11.9, 95% CI 2.7-62.4); and severe disease per the WHO Clinical Progression Scale (OR 11.7, 95% CI 2.1-90.5). Upon subgroup analyses, omicron was independently associated with ICU admission and severe disease per the WHO Clinical Progression Scale in children without SARS-CoV-2 immunization or prior COVID-19 infection.
Conclusions: Compared to non-VOC COVID-19, the gamma VOC was independently associated with increased COVID-19 severity, as was omicron in children without SARS-CoV-2 immunization or prior COVID-19 infection. SARS-CoV-2 vaccination and prior COVID-19 prevented severe outcomes during the omicron surge.
Keywords: COVID-19; SARS-CoV-2; children; outcomes; severity.
. 2022 Aug 4;piac068.
doi: 10.1093/jpids/piac068. Online ahead of print.
Severity of Illness Caused by Severe Acute Respiratory Syndrome Coronavirus 2 Variants of Concern in Children: A Single-Center Retrospective Cohort Study
Priya R Edward[SUP] 1 [/SUP], Ramon Lorenzo-Redondo[SUP] 2 3 [/SUP], Megan E Reyna[SUP] 1 [/SUP], Lacy M Simons[SUP] 2 3 [/SUP], Judd F Hultquist[SUP] 2 3 [/SUP], Ami B Patel[SUP] 1 2 [/SUP], Egon A Ozer[SUP] 2 3 [/SUP], William J Muller[SUP] 1 2 [/SUP], Taylor Heald-Sargent[SUP] 1 2 [/SUP], Matthew McHugh[SUP] 1 [/SUP], Taylor Dean[SUP] 2 3 [/SUP], Raj M Dalal[SUP] 2 [/SUP], Jordan John[SUP] 2 [/SUP], Shannon C Manz[SUP] 2 [/SUP], Larry K Kociolek[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35924454
- DOI: 10.1093/jpids/piac068
Abstract
Background: Recent COVID-19 surges are attributed to emergence of more transmissible SARS-CoV-2 variants of concern (VOCs). The relative severity of VOCs in children is unknown.
Methods: We performed a single-center retrospective cohort study of children ≤18 years old diagnosed with COVID-19 from October 2020-February 2022 and whose SARS-CoV-2 isolate underwent Illumina sequencing. We measured the frequency of five markers of COVID-19 severity. Logistic regression models were fitted to estimate the odds of each severity marker with each VOC.
Results: Among 714 children, 471 (66.0%) were infected with a VOC: 96 (13.4%) alpha, 38 (5.3%) gamma, 119 (16.7%) delta, and 215 (30.1%) omicron. High-risk medical conditions and increasing age were independently associated with COVID-19 severity. After adjusting for age, race, ethnicity, high-risk medical conditions, and COVID-19 community incidence, neither alpha, delta, nor omicron was associated with severe COVID-19. Gamma was independently associated with hospitalization (OR 6.7, 95% CI 2.0-22.1); pharmacologic treatment (OR 5.7, 95% CI 1.2-26.8); respiratory support (OR 11.9, 95% CI 2.7-62.4); and severe disease per the WHO Clinical Progression Scale (OR 11.7, 95% CI 2.1-90.5). Upon subgroup analyses, omicron was independently associated with ICU admission and severe disease per the WHO Clinical Progression Scale in children without SARS-CoV-2 immunization or prior COVID-19 infection.
Conclusions: Compared to non-VOC COVID-19, the gamma VOC was independently associated with increased COVID-19 severity, as was omicron in children without SARS-CoV-2 immunization or prior COVID-19 infection. SARS-CoV-2 vaccination and prior COVID-19 prevented severe outcomes during the omicron surge.
Keywords: COVID-19; SARS-CoV-2; children; outcomes; severity.