tetano
Editor, Senior Moderator
Sci Rep
. 2025 Oct 21;15(1):36638.
doi: 10.1038/s41598-025-20483-y. Clinical manifestations and severity of COVID-19 caused by Omicron among paediatric patients aged 0-17 years in Italy
Rossana Scutari[SUP] #[/SUP][SUP] 1 [/SUP], Valeria Fox[SUP] #[/SUP][SUP] 1 [/SUP], Jennifer L Nguyen[SUP] 2 [/SUP], Luna Colagrossi[SUP] 3 [/SUP], Andrea Smarrazzo[SUP] 4 [/SUP], Anna Chiara Vittucci[SUP] 5 [/SUP], Laura Cursi[SUP] 6 [/SUP], Martina Mastropaolo[SUP] 1 [/SUP], Lorena Forquè Rodriguez[SUP] 1 [/SUP], Carmen D'amore[SUP] 7 [/SUP], Luciano Pacelli[SUP] 2 [/SUP], Mustapha M Mustapha[SUP] 2 [/SUP], Claudia Alteri[SUP] 8 [/SUP], Jingyan Yang[SUP] 2 [/SUP], Antonella De Santis[SUP] 4 [/SUP], Romina Quercia[SUP] 2 [/SUP], Alessandra Pagliaro[SUP] 2 [/SUP], Annarita Granaglia[SUP] 3 [/SUP], Vanessa Fini[SUP] 3 [/SUP], Srinivas R Valluri[SUP] 2 [/SUP], Cristina Russo[SUP] 3 [/SUP], Catia Marques[SUP] 2 [/SUP], John M McLaughlin[SUP] 2 [/SUP], Laura Lancella[SUP] 6 [/SUP], Marta Luisa Ciofi Degli Atti[SUP] 7 [/SUP], Andrea Campana[SUP] 4 [/SUP], Massimiliano Raponi[SUP] 9 [/SUP], Alberto Villani[SUP] 5 [/SUP], Carlo Federico Perno[SUP] 10 11 [/SUP]
Affiliations
SARS-CoV-2 Omicron variant evolved into multiple sub-lineages, some showing increased transmissibility and immune evasion. Despite decreased risk of severe disease, paediatric hospitalization rose. However, factors influencing clinical outcomes remain unclear. A total of 458 whole-genome Omicron sequences from patients 0-17 years, diagnosed with SARS-CoV-2 at Bambino Gesù Children's Hospital (January-December 2023) were analysed. Clinical features, disease severity and circulating variants were assessed. Phylogenetic analysis was performed, and logistic regression identified factors associated with hospitalization. Among patients, 249 (54.4%) were male, with median age 0.6 years. Comorbidities were present in 105 (22.9%) patients, mainly immunocompromised (21.0%). Infections were predominantly from XBB (75.0%), JN.1 (12.4%), BA.5 (7.4%) and BA.2 (5.2%) clades. Upper respiratory infections predominated (73.8%), followed by asymptomatic (17.2%) and lower respiratory infections (4.6%), with nine patients having ≥ 1 co-infection. Comorbidities and lower respiratory infections were positively associated with hospitalization, while upper respiratory infections showed a negative association. Given the recent shift to RGN integrin-binding motif in Omicron sub-lineages, leading to altered pathogenesis, its presence was evaluated, revealing a predominance of RGN (N = 378, 84.6%). In conclusion, COVID-19 severity in paediatric patients was primarily driven by comorbidities and co-infections, while milder cases in healthy children may be associated with RGN integrin-binding motif.
Keywords: COVID-19 in children; Clinical outcomes; Omicron clade; SARS-CoV-2 genomic characterization.
. 2025 Oct 21;15(1):36638.
doi: 10.1038/s41598-025-20483-y. Clinical manifestations and severity of COVID-19 caused by Omicron among paediatric patients aged 0-17 years in Italy
Rossana Scutari[SUP] #[/SUP][SUP] 1 [/SUP], Valeria Fox[SUP] #[/SUP][SUP] 1 [/SUP], Jennifer L Nguyen[SUP] 2 [/SUP], Luna Colagrossi[SUP] 3 [/SUP], Andrea Smarrazzo[SUP] 4 [/SUP], Anna Chiara Vittucci[SUP] 5 [/SUP], Laura Cursi[SUP] 6 [/SUP], Martina Mastropaolo[SUP] 1 [/SUP], Lorena Forquè Rodriguez[SUP] 1 [/SUP], Carmen D'amore[SUP] 7 [/SUP], Luciano Pacelli[SUP] 2 [/SUP], Mustapha M Mustapha[SUP] 2 [/SUP], Claudia Alteri[SUP] 8 [/SUP], Jingyan Yang[SUP] 2 [/SUP], Antonella De Santis[SUP] 4 [/SUP], Romina Quercia[SUP] 2 [/SUP], Alessandra Pagliaro[SUP] 2 [/SUP], Annarita Granaglia[SUP] 3 [/SUP], Vanessa Fini[SUP] 3 [/SUP], Srinivas R Valluri[SUP] 2 [/SUP], Cristina Russo[SUP] 3 [/SUP], Catia Marques[SUP] 2 [/SUP], John M McLaughlin[SUP] 2 [/SUP], Laura Lancella[SUP] 6 [/SUP], Marta Luisa Ciofi Degli Atti[SUP] 7 [/SUP], Andrea Campana[SUP] 4 [/SUP], Massimiliano Raponi[SUP] 9 [/SUP], Alberto Villani[SUP] 5 [/SUP], Carlo Federico Perno[SUP] 10 11 [/SUP]
Affiliations
- PMID: 41120462
- PMCID: PMC12540900
- DOI: 10.1038/s41598-025-20483-y
SARS-CoV-2 Omicron variant evolved into multiple sub-lineages, some showing increased transmissibility and immune evasion. Despite decreased risk of severe disease, paediatric hospitalization rose. However, factors influencing clinical outcomes remain unclear. A total of 458 whole-genome Omicron sequences from patients 0-17 years, diagnosed with SARS-CoV-2 at Bambino Gesù Children's Hospital (January-December 2023) were analysed. Clinical features, disease severity and circulating variants were assessed. Phylogenetic analysis was performed, and logistic regression identified factors associated with hospitalization. Among patients, 249 (54.4%) were male, with median age 0.6 years. Comorbidities were present in 105 (22.9%) patients, mainly immunocompromised (21.0%). Infections were predominantly from XBB (75.0%), JN.1 (12.4%), BA.5 (7.4%) and BA.2 (5.2%) clades. Upper respiratory infections predominated (73.8%), followed by asymptomatic (17.2%) and lower respiratory infections (4.6%), with nine patients having ≥ 1 co-infection. Comorbidities and lower respiratory infections were positively associated with hospitalization, while upper respiratory infections showed a negative association. Given the recent shift to RGN integrin-binding motif in Omicron sub-lineages, leading to altered pathogenesis, its presence was evaluated, revealing a predominance of RGN (N = 378, 84.6%). In conclusion, COVID-19 severity in paediatric patients was primarily driven by comorbidities and co-infections, while milder cases in healthy children may be associated with RGN integrin-binding motif.
Keywords: COVID-19 in children; Clinical outcomes; Omicron clade; SARS-CoV-2 genomic characterization.