Related Experiment Video
Updated: Oct 3, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Comparison of COVID-19 Infection in Children During the First and Second Wave
Sriram Krishnamurthy1, Sitanshu Sekhar Kar2, Rahul Dhodapkar3
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India. drsriramk@yahoo.com.
Insights
Media concerns about a severe third wave of COVID-19 in children are unlikely. This study found similar, mild infection patterns in children during the first and second waves, suggesting low risk for future waves.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Media reports suggested the third wave of SARS-CoV-2 would severely impact children.
- Understanding pediatric COVID-19 infection trends is crucial for public health preparedness.
Purpose of the Study:
- To analyze and compare the clinical presentation and outcomes of SARS-CoV-2 infection in children during the first and second waves.
- To assess the risk of severe COVID-19 and MIS-C (multisystem inflammatory syndrome in children) in pediatric populations.
Main Methods:
- Retrospective analysis of 8,626 SARS-CoV-2 RT-PCR tests in children (0-17 years) from March 2020 to July 2021.
- Comparison of infection rates, symptom severity, and outcomes between the first (July 2020-Jan 2021) and second (Feb 2021-July 2021) waves.
- Identification and analysis of pediatric cases of MIS-C.
Main Results:
- Overall pediatric SARS-CoV-2 positivity rate was 17% (14.7% in wave 1, 21.2% in wave 2).
- The majority of infected children were mildly symptomatic or asymptomatic in both waves (74.1% vs. 80.2%).
- No cases of COVID-19 pneumonia were observed; five deaths (0.3%) were attributed to underlying non-COVID conditions. 73 MIS-C cases had low mortality (2.7%).
Conclusions:
- Pediatric COVID-19 infection presentation remained consistent between the first and second waves.
- The findings suggest a low likelihood of the third wave severely affecting children.
- Continued surveillance for MIS-C in children is warranted.
Abstract:
Concerns have been raised in the media that 'the third wave' will severely affect children. Here, an experience of SARS-CoV-2 infection in children is reported. Of the 8,626 SARS-CoV-2 RT-PCR tests performed in children (0-17 y) from March 2020 to July 2021 at the authors' institute, 1470 (17%) were positive, [711/4821 (14.7%) during the first wave (July 2020 to January 2021), and 759/3583 (21.2%) during the second wave (February 2021 to July 2021)]. The children in both waves were similar in presentation (74.1% mildly symptomatic versus 80.2% mildly symptomatic; rest asymptomatic). None of them had COVID pneumonia. Five children died (0.3%), all of a serious primary non-COVID disease. Seventy-three cases of MIS-C during August 2020 to July 2021, with low mortality (2.7%) were also identified. The similarity in COVID-19 infection in children between the first and the second waves seems to suggest that the likelihood of the 'third wave' hitting children hard is low.
