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Published on: February 3, 2023

Burden of COVID-19 in Korean Children: A Retrospective Observational Study Using Real-world Data

Young Hwa Lee1, Eunseon Gwak2, Young June Choe1,3

  • 1From the Allergy and Immunology Center, Korea University, Seoul, Republic of Korea.

The Pediatric Infectious Disease Journal
|June 16, 2026
PubMed

Insights

The Omicron variant significantly increased pediatric COVID-19 cases in South Korea, with younger children and those with comorbidities facing severe outcomes. Vaccination showed limited protection against severe COVID-19 in children.

Area of Science:

  • Pediatric infectious diseases
  • Epidemiology
  • Public health

Background:

  • Children initially showed lower susceptibility to COVID-19, but variants and eased measures increased pediatric burden.
  • This study examines pediatric COVID-19 trends in South Korea across seven epidemic waves.

Purpose of the Study:

  • To characterize pediatric COVID-19 features in South Korea.
  • To evaluate the impact of vaccination and comorbidities on disease severity in children.

Main Methods:

  • Retrospective analysis of the national K-COV-N database (January 2020-August 2023).
  • Inclusion of 239,334 children aged 1-17 with confirmed COVID-19.
  • Logistic regression to identify risk factors for severity, stratified by age and variant waves.

Main Results:

  • Omicron waves (5-7) comprised 97.88% of cases; younger children (1-4 years) had severe outcomes.
  • Hospital stays decreased, but mortality and multisystem inflammatory syndrome in children (MIS-C) peaked during Omicron.
  • Cardiovascular disease, neurologic disorders, and obesity were independent risk factors for severity; vaccination had limited protective effects.

Conclusions:

  • Pediatric COVID-19 shifted to widespread Omicron transmission, with high prevalence despite lower individual severity.
  • Targeted protection for high-risk children and robust healthcare planning are crucial for future outbreaks.
Abstract

Keywords:
COVID-19Republic of KoreaSARS-CoV-2 variantscost of illnessdisease outbreakspediatricsvaccines

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