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Updated: Jul 21, 2025
Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
Impact of the omicron phase on a highly advanced medical facility in Japan
Hirokazu Yamagishi1, Daisuke Tamura1, Jun Aoyagi1
1Department of Pediatrics, Jichi Medical University, Shimotsuke-shi, Japan.
Insights
Pediatric COVID-19 patients, particularly after the Omicron wave, showed increased convulsions and acute encephalopathy. While severe illness rates remained stable, critical complications like hypercytokinemia and encephalopathy syndrome were observed.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- The coronavirus disease 2019 (COVID-19) epidemic has seen eight waves in Japan.
- Understanding the clinical profile of pediatric COVID-19 cases is crucial.
Purpose of the Study:
- To clarify the clinical characteristics of pediatric COVID-19 patients in Japan.
- To analyze hospitalization and severe illness rates in relation to COVID-19 waves.
Main Methods:
- Retrospective study of 121 pediatric patients admitted between April 2020 and March 2023.
- Analysis of hospitalization and severe illness rates using prefectural incidence data.
Main Results:
- Most hospitalizations (91.7%) occurred after January 2022 (post-6th wave), coinciding with the Omicron variant.
- Convulsions (24.8%) and acute encephalopathy (9.1%) were noted, particularly in previously healthy children after the 6th wave.
- One death occurred due to encephalopathy syndrome with hypercytokinemia; two patients had sequelae. Severe illness rates did not significantly change post-6th wave.
Conclusions:
- Despite stable overall severe illness rates, pediatric COVID-19 can lead to critical complications like severe encephalopathy.
- Systemic inflammatory responses are implicated in the development of severe encephalopathy in pediatric COVID-19 cases.
Background:
Eight waves of the coronavirus disease 2019 (COVID-19) epidemic have been observed in Japan. This retrospective study was conducted to clarify the clinical characteristics of pediatric COVID-19 patients.
Methods:
We studied 121 patients admitted to the Jichi Children's Medical Center Tochigi between April 2020 and March 2023. Incidence of pediatric COVID-19 in Tochigi Prefecture was used to examine hospitalization and severe illness rates.
Results:
The mean age of the patients was 3 years and 8 months. One hundred and eleven patients (91.7%) were hospitalized after January 2022 (after the 6th wave), when the Omicron strain became endemic in Japan. Convulsions occurred in 30 patients (24.8%), all of whom were admitted after the 6th wave. Twenty-three of the 30 patients had no underlying disease. Eleven patients (9.1%) were diagnosed with acute encephalopathy. One patient died due to hemorrhagic shock and encephalopathy syndrome and two had sequelae after the 6th wave. The patient who died due to encephalopathy had hypercytokinemia. In the Tochigi Prefecture, the number of pediatric COVID-19 patients increased after the 6th wave, but the hospitalization rate declined. The rate of severe illness did not change before the end of 5th and after the 6th wave.
Conclusion:
Although the rate of severe illness in patients with pediatric COVID-19 did not increase after the 6th wave, some patients had complicated critical illnesses. Systemic inflammatory reaction was considered to have been associated with the severe encephalopathy.
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