Critically ill infants with SARS-COV-2 delta variant infection

Area of Science:

• Pediatric Intensive Care
• Infectious Diseases
• Virology

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically causes mild to moderate symptoms in children.
• Limited clinical data exists on the specific symptoms and outcomes of the Delta variant in pediatric patients, particularly infants.

Approach:

• A retrospective study was conducted between June 23, 2021, and August 16, 2021, during the Delta variant's predominance.
• Infants under 15 years old admitted to the pediatric intensive care unit (PICU) with severe or critical SARS-CoV-2 infection (confirmed by RT-PCR) were included.
• Medical records were reviewed to gather clinical characteristics and outcomes.

Key Points:

• Twenty infants, with a median age of 47 days and no underlying conditions, were included.
• Respiratory involvement, including pediatric acute respiratory distress (PARDS), was the primary clinical feature.
• Eleven patients developed PARDS, with 7 requiring mechanical ventilation, and 4 patients died.

Conclusions:

• The SARS-CoV-2 Delta variant can cause life-threatening illness in very young infants, even those without comorbidities.
• This case series underscores the severe respiratory and hemodynamic impact of the Delta variant in a vulnerable pediatric population.
• Findings emphasize the need for vigilant monitoring and management strategies for infants during periods of high SARS-CoV-2 variant circulation.