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Published on: November 5, 2021
SARS-CoV-2 Serostatus and COVID-19 Illness Characteristics by Variant Time Period in Non-Hospitalized Children and
Sarah E Messiah1,2,3, Michael D Swartz4, Rhiana A Abbas4
1Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health in Dallas, The University of Texas (UT) Health Science Center at Houston, Dallas, TX 77030, USA.
Insights
Symptomatic COVID-19 infections increased in children with each new variant. Vaccination remains crucial for eligible children to stay protected against severe illness.
Area of Science:
- Pediatric infectious diseases
- Virology
- Epidemiology
Background:
- COVID-19 continues to affect children globally.
- Understanding variant-specific illness characteristics is vital for public health strategies.
- Pediatric data on SARS-CoV-2 infection trends are essential.
Purpose of the Study:
- To characterize COVID-19 illness, risk factors, and SARS-CoV-2 serostatus in children.
- To analyze these factors across different variant time periods.
- To assess the impact of vaccination status on infection risk.
Main Methods:
- Prospective cohort study of 3911 children aged 5-19 years in Texas.
- Data collected from October 2020 to November 2022.
- SARS-CoV-2 antibody status assessed using Roche N-test; self-reported symptoms and test results collected.
Main Results:
- Over half (57.2%) of participants were antibody positive.
- Symptomatic infection rates rose from 47.09% (pre-Delta) to 94.79% (Omicron BA.2).
- Unvaccinated children had a higher likelihood of infection (OR 1.71) compared to vaccinated children.
Conclusions:
- Symptomatic COVID-19 increased in non-hospitalized children with successive variants.
- Findings underscore the importance of up-to-date COVID-19 vaccination for children.
- This study provides critical insights into pediatric COVID-19 trends during the pandemic.
Objective:
To describe COVID-19 illness characteristics, risk factors, and SARS-CoV-2 serostatus by variant time period in a large community-based pediatric sample.
Design:
Data were collected prospectively over four timepoints between October 2020 and November 2022 from a population-based cohort ages 5 to 19 years old.
Setting:
State of Texas, USA.
Participants:
Participants ages 5 to 19 years were recruited from large pediatric healthcare systems, Federally Qualified Healthcare Centers, urban and rural clinical practices, health insurance providers, and a social media campaign.
Exposure:
SARS-CoV-2 infection.
Main Outcome(S) And Measure(S):
SARS-CoV-2 antibody status was assessed by the Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for detection of antibodies to the SARS-CoV-2 nucleocapsid protein (Roche N-test). Self-reported antigen or PCR COVID-19 test results and symptom status were also collected.
Results:
Over half (57.2%) of the sample (N = 3911) was antibody positive. Symptomatic infection increased over time from 47.09% during the pre-Delta variant time period, to 76.95% during Delta, to 84.73% during Omicron, and to 94.79% during the Omicron BA.2. Those who were not vaccinated were more likely (OR 1.71, 95% CI 1.47, 2.00) to be infected versus those fully vaccinated.
Conclusions:
Results show an increase in symptomatic COVID-19 infection among non-hospitalized children with each progressive variant over the past two years. Findings here support the public health guidance that eligible children should remain up to date with COVID-19 vaccinations.
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