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[Clinical features of children with coronavirus disease 2019 caused by Delta variant infection in different age
Hang Su1, Feng-Yang Duan1, Xian-Qing Ren1
1Department of Pediatrics, First Affiliated Hospital of Henan University of Traditional Chinese Medicine/College of Pediatrics, Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China.
Insights
COVID-19 Delta variant infection presents differently in children across age groups. Younger children may show myocardial injury, while older children experience fever, renal, and immune dysfunction, indicating varied clinical features.
Area of Science:
- Pediatric infectious diseases
- Viral variant clinical manifestations
- Epidemiology of COVID-19 in children
Context:
- The Delta variant of SARS-CoV-2 caused widespread COVID-19 infections globally.
- Understanding age-specific clinical presentations in pediatric populations is crucial for effective management.
- Previous studies on pediatric COVID-19 have not always detailed variant-specific differences across distinct age strata.
Purpose:
- To investigate and compare the clinical and laboratory features of COVID-19 in children infected with the Delta variant across three age groups: <6 years, 6-13 years, and >13 years.
- To identify age-related variations in symptoms, laboratory findings, and immune responses in pediatric patients with Delta variant COVID-19.
Summary:
- A study of 45 hospitalized children with Delta variant COVID-19 in Henan Province, China, revealed mild illness overall.
- Key differences included myocardial injury markers in the <6 years group, fever and renal/immune dysfunction in the 6-13 years group, and higher SARS-CoV-2 IgG positivity in the >13 years group.
- Cough and expectoration were common across all groups, while fever was noted only in the 6-13 years group. Chest CT findings were similar across groups.
Impact:
- This research highlights distinct clinical trajectories of Delta variant COVID-19 in children based on age.
- Findings can inform targeted clinical monitoring and treatment strategies for pediatric COVID-19 patients.
- Provides valuable data for public health responses to viral respiratory illnesses in diverse pediatric age demographics.
Objectives:
To study the clinical features of children with coronavirus disease 2019 (COVID-19) caused by Delta variant infection in different ages groups.
Methods:
A total of 45 children with COVID-19 caused by Delta variant infection who were hospitalized in the designated hospital in Henan Province, China, from November 17 to December 17, 2021, were included. They were divided into three groups: <6 years group (n=16), 6-13 years group (n=16), and >13 years group (n=13). The three groups were compared in clinical features and laboratory examination data.
Results:
COVID-19 in all age groups was mainly mild. Main manifestations included cough and expectoration in the three groups, and fever was only observed in the 6-13 years group. The <6 years group had significantly higher serum levels of aspartate aminotransferase, lactate dehydrogenase, and creatine kinase isoenzymes than the other two groups (P<0.05). The 6-13 years group had the highest proportion of children with elevated serum creatinine levels (50%). Among the three groups, only 4 children in the >13 years group had an increase in serum C-reactive protein levels. The 6-13 years group had the lowest counts of CD3+CD4+ lymphocytes, CD3+CD8+ lymphocytes, and natural killer cells in the peripheral blood among the three groups. The >13 years group had a significantly higher positive rate of SARS-CoV-2 IgG on admission than the other two groups (P<0.05). There was no significant difference in the imaging findings on chest CT among the three groups (P>0.05).
Conclusions:
The clinical features of COVID-19 caused by Delta variant infection in children of different age groups may be different: children aged <6 years tend to develop myocardial injury, and those aged 6-13 years have fever except cough and expectoration and tend to develop renal and immune dysfunction.
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