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Impact of Variants, Epidemiological Trends, and Comorbidities on Hospitalization Rates of Unvaccinated Children in

Danielle Dias Conte1, Raí André Silva Watanabe1, Ana Paula Cunha Chaves1

  • 1Infectious Diseases Division, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.

Influenza and Other Respiratory Viruses
|December 17, 2024
PubMed

Insights

New COVID-19 variants increased hospitalizations in unvaccinated Brazilian children. Prioritizing Omicron XBB vaccination for high-risk children over 5 with comorbidities is crucial to reduce severe outcomes.

Area of Science:

  • Pediatric infectious diseases
  • Epidemiology
  • Public health

Background:

  • The emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and evolving epidemiological scenarios have impacted pediatric populations.
  • Understanding hospitalization trends in unvaccinated children is crucial for public health strategies.

Purpose of the Study:

  • To investigate the impact of new SARS-CoV-2 variants and epidemiology on hospitalization rates in unvaccinated children (0-12 years) in Brazil.
  • To identify risk factors and outcomes associated with COVID-19 in hospitalized children.

Main Methods:

  • Retrospective study of 1614 children admitted between March 2020 and December 2022.
  • Analysis of 101 children who tested positive for COVID-19 via RT-PCR.
  • Evaluation of demographic data, comorbidities, reasons for hospitalization, coinfections, readmissions, and mortality.

Main Results:

  • COVID-19 hospitalizations increased from 7.5% in 2020 to 9.3% in 2022, coinciding with the Omicron variant.
  • Children over 5 years old with comorbidities (e.g., sickle cell anemia) represented the majority of cases (69%).
  • Influenza-like illness (36%) and underlying disease decompensation (33%) were primary admission reasons. Respiratory Syncytial Virus (RSV) was the most common coinfection (71%).
  • Hospital readmission was 26%, and the death rate was 1.9%, with cystic fibrosis and congenital heart disease as risk factors.

Conclusions:

  • The emergence of variants like Omicron has influenced COVID-19 hospitalization rates in unvaccinated children.
  • Children over 5 with comorbidities are at higher risk for severe outcomes.
  • Vaccination with monovalent Omicron XBB is recommended for high-risk pediatric groups to mitigate severe disease.

Keywords:
COVID‐19childrencoinfectioncomorbiditiesvaccine

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