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Clinical Outcomes of Children With COVID-19 by SARS-CoV-2 Strain: A Cohort Study

Lauren M Klingensmith1, Swati Goel1, Vinay N Kampalath2

  • 1From the Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.

Pediatric Emergency Care
|September 4, 2023
PubMed

Insights

The Delta variant of SARS-CoV-2 did not significantly alter disease severity in children compared to earlier strains. Children aged 1-4 years and those with public insurance were more likely to be hospitalized.

Area of Science:

  • Pediatric infectious diseases
  • Virology
  • Public health

Background:

  • The emergence of SARS-CoV-2 variants, such as Delta, necessitated an understanding of their impact on pediatric disease severity.
  • Previous studies have not fully elucidated the comparative outcomes of SARS-CoV-2 Delta variant infections in children.

Purpose of the Study:

  • To compare disease outcomes and identify predictors of severe outcomes in children infected with the SARS-CoV-2 Delta variant versus pre-Delta strains.
  • To assess the influence of comorbidities on hospitalization rates in pediatric Delta variant infections.

Main Methods:

  • Retrospective cohort study conducted at a single urban academic children's hospital emergency department.
  • Inclusion criteria: children aged 0-18 years with a positive SARS-CoV-2 test.
  • Primary outcomes: hospital admission and COVID-directed therapies.

Main Results:

  • A trend towards decreased hospital admission was observed in the Delta variant cohort, though not statistically significant (OR, 0.79; 95% CI, 0.51-1.23).
  • Predictors of hospital admission included age 1-4 years (OR, 2.35; 95% CI, 1.23-4.57) and public insurance (OR, 1.80; 95% CI, 1.08-3.01).
  • Comorbidities increased odds of admission within the Delta cohort (OR, 2.52; 95% CI, 1.09-6.04), while Black children had lower odds of admission than white children.

Conclusions:

  • Disease severity outcomes were similar between pediatric patients infected with SARS-CoV-2 pre-Delta and Delta variants, even in those with comorbidities.
  • Continued research is crucial to monitor disease severity and risks in children, particularly with ongoing SARS-CoV-2 mutations like Omicron subvariants.
Abstract

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