Omicron in Infants-Respiratory or Digestive Disease?

Area of Science:

• Pediatric Infectious Diseases
• Virology
• Public Health

Background:

• The Omicron variant of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) led to widespread infections, including in the pediatric population.
• Infants, due to their immature immune systems, are particularly vulnerable to viral infections, potentially experiencing more severe outcomes.
• Understanding the specific clinical manifestations and outcomes in infants during the Omicron wave is crucial for timely medical intervention.

Purpose of the Study:

• To characterize the clinical features and outcomes of infants hospitalized with confirmed SARS-CoV-2 infection during the Omicron variant surge.
• To identify age-specific clinical presentations and risk factors associated with COVID-19 in infants.
• To inform clinical management and public health strategies for pediatric COVID-19.

Main Methods:

• A retrospective study was conducted on 613 infants hospitalized with symptomatic COVID-19 and no co-infections.
• Data were collected from January to September 2022 at a major infectious diseases hospital in Bucharest, Romania.
• Clinical features, laboratory values (including alanine aminotransferase - ALT), and hospitalization duration were analyzed, with a focus on age-related differences.

Main Results:

• Fever (96.4%), cough (64.8%), and loss of appetite (63.3%) were the predominant symptoms, with respiratory symptoms affecting 76.0% of infants.
• Infants aged 1-3 months showed a 1.5-fold increased risk of elevated ALT and longer hospitalizations compared to older infants.
• Infants aged 7-9 months had higher incidences of loss of appetite, cough, and digestive symptoms, and the presence of digestive symptoms correlated with a 1.9-fold increased probability of elevated ALT.

Conclusions:

• Infants hospitalized with COVID-19 during the Omicron wave presented with significant respiratory and systemic symptoms.
• Age-specific differences in clinical presentation and outcomes, including hepatic involvement, were observed in infants.
• Continuous monitoring of SARS-CoV-2 in infants is essential to adapt clinical management strategies to evolving viral variants and their impact.