August 9, 2023
In a study covered by Healio, experts in the United Kingdom identified epidemiologic nuances in children with COVID-19. The study covered the first two years of the pandemic and found risk of severe COVID remained low, though multiple comorbidities provided greater risk for severe outcomes after infection with each variant wave. Study authors used COVID and MIS-C data from nationwide inpatient activity from February 2020 to January 2022. It included 10,540 hospitalizations due to COVID-19 and 997 due to MIS-C.
Increases in hospitalizations among children and adolescents corresponding to the delta and omicron variant periods raised concerns that children and adolescents had become more vulnerable. Study authors, however, say the rise likely reflected variations in infection rates and incidental infections among those hospitalized, rather than more severity. Nearly all (93.2%) hospitalizations were patients without prior exposure or vaccination.
Overall, 4.3% of those children and adolescents that were hospitalized would go to the pediatric intensive care unit. Even that percentage of those hospitalized admitted to the PICU declined with each successive wave, dropping from 9.9% for the original COVID-19 strain to 1.7% during omicron. This finding adds to prior research on omicron that showed the variant was associated with the lowest rates of hospitalization and PICU admission despite its high infectiousness.
PIDS member Kathleen Chiotos co-authored an accompanying editorial. It said the study “At a stage of the pandemic where severe illness from SARS-CoV-2 is fortunately exceedingly rare in children, it is perhaps that which is not measured in this report that represents our greatest imperative: addressing the decrement in child physical and mental health indirectly related to the COVID-19 pandemic and the resulting mitigation strategies. Overcoming these secondary pandemic effects will require complex solutions, including expanding child mental health services, promoting access to routine child vaccinations and preventive health care, and investments in community and public school-based programs, particularly those focused on socio-demographically disadvantaged groups who have been impacted by widened health care disparities during the pandemic.”