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Comparison of UK paediatric SARS-CoV-2 admissions across the first and second pandemic waves

Olivia V Swann1,2, Louisa Pollock2,3, Karl A Holden4,5

  • 1Department of Child Life and Health, University of Edinburgh, Edinburgh, UK.

Pediatric Research
|April 22, 2022
PubMed

Insights

Hospitalised children and young people (CYP) with SARS-CoV-2 showed no increased disease severity in the UK's second wave compared to the first. Many admitted CYP had no comorbidities, experiencing shorter stays and less support.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Clinical characteristics of hospitalised children and young people (CYP) with SARS-CoV-2 were compared between the first (W1) and second (W2) waves in the UK.
  • Hypothesised differences were attributed to the emergence of the alpha variant (B.1.1.7), school reopenings, and eased shielding measures.

Purpose of the Study:

  • To investigate if clinical characteristics of hospitalised CYP with SARS-CoV-2 differed between the first and second waves in the UK.
  • To assess disease severity and identify patient demographics, including comorbidities, during different pandemic phases.

Main Methods:

  • A prospective multicentre observational cohort study included CYP (<19 years) hospitalised with SARS-CoV-2 in the UK from January 2020 to January 2021.
  • Clinical data were compared between W1 (17/01/20–31/07/20) and W2 (01/08/20–31/01/21), excluding asymptomatic/incidental cases and those with Multisystem Inflammatory Syndrome in Children (MIS-C) for specific analyses.

Main Results:

  • Of 1617 symptomatic CYP, 16.0% required critical care, and 0.8% died. 5.6% developed MIS-C.
  • Excluding MIS-C cases, W2 showed lower Paediatric Early Warning Scores (PEWS), reduced antibiotic use, and less respiratory/cardiovascular support compared to W1.
  • The proportion of CYP admitted to critical care remained unchanged; 58.0% had no reported comorbidities, with younger patients (<1 year) experiencing less severe outcomes.

Conclusions:

  • No evidence of increased COVID-19 disease severity was found in hospitalised CYP during the second wave compared to the first.
  • A significant proportion of hospitalised CYP lacked comorbidities, and when MIS-C cases were excluded, these patients had better outcomes than those with comorbidities.
  • Approximately 20% of admitted CYP had asymptomatic or incidental SARS-CoV-2 infections.
Abstract

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