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COVID-19 Hospitalization Among Children <18 Years by Variant Wave in Norway

Robert Whittaker1, Margrethe Greve-Isdahl1, Håkon Bøås2

  • 1Departments of Infection Control and Vaccines.

Pediatrics
|August 2, 2022
PubMed

Insights

This study found that the Omicron variant did not increase the risk of hospitalization for acute COVID-19 in unvaccinated children compared to the Alpha variant. However, Omicron significantly reduced the risk of multisystem inflammatory syndrome in children (MIS-C).

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Limited evidence exists on the differential severity of COVID-19 across SARS-CoV-2 variants in pediatric populations.
  • Understanding variant-specific risks for acute COVID-19 and MIS-C is crucial for public health strategies.

Purpose of the Study:

  • To compare the risk of hospitalization due to acute COVID-19 and MIS-C among unvaccinated children and adolescents across different SARS-CoV-2 variant waves (Alpha, Delta, Omicron BA.1) in Norway.
  • To assess if variant type influences the relative severity of COVID-19 outcomes in pediatric populations.

Main Methods:

  • Utilized linked individual-level data from national registries in Norway.
  • Employed multivariable log-binomial regression to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).
  • Adjusted for variant wave, demographic factors, and underlying comorbidities in unvaccinated individuals under 18 years.

Main Results:

  • Hospitalization risk for acute COVID-19 was lower during the Delta (aRR: 0.53) and Omicron (aRR: 0.40) waves compared to the Alpha wave.
  • No significant difference in acute COVID-19 hospitalization risk was observed between the Delta and Omicron waves.
  • The risk of MIS-C was substantially lower during the Omicron wave compared to both Alpha (aRR: 0.09) and Delta (aRR: 0.26) waves.

Conclusions:

  • No clear evidence suggests that different SARS-CoV-2 variants significantly influenced the risk of acute COVID-19 hospitalization in unvaccinated Norwegian children and adolescents.
  • Observed reductions in acute COVID-19 hospitalization risk with Delta and Omicron may be attributed to factors beyond viral variant, such as testing strategies or vaccination status.
  • The Omicron variant demonstrated a significant reduction in the risk of developing MIS-C.
Abstract

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