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Comparative study of COVID-19 patients admitted during the first and second waves in a tertiary care hospital in

Dharmraj Maurya1, Ankur Kumar2, Anita Mehta3

  • 1Neonatologist, Private Practice, Divlok Hospital and Child Care Center, Varanasi, India.

Sudanese Journal of Paediatrics
|August 2, 2026
PubMed

Insights

The second wave of COVID-19 in India saw more severe illness and higher mortality in children compared to the first wave. Younger children, including neonates, were disproportionately affected during the second wave, indicating a shift in disease presentation.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, presented significant global health challenges with high mortality.
  • The pandemic evolved in waves, necessitating an understanding of disease dynamics across different periods.

Purpose of the Study:

  • To compare the clinical characteristics and outcomes of pediatric COVID-19 patients during the first and second waves of the pandemic in India.
  • To identify demographic and clinical differences in children affected by COVID-19 during distinct pandemic phases.

Main Methods:

  • A single-center retrospective study was conducted at a dedicated COVID-19 hospital in India.
  • Data from 104 pediatric patients (<18 years) were analyzed, comparing the first wave (March-November 2020) and the second wave (March-May 2021).

Main Results:

  • The second wave saw a shift towards younger children (<5 years) and neonates being affected, compared to older children in the first wave.
  • Severe-grade illness, respiratory distress, acidosis, and lower oxygen saturation were significantly higher in the second wave.
  • Intensive care unit (ICU) admission, need for respiratory support (CPAP/BIPAP), blood products, and mortality rates were significantly elevated during the second wave.

Conclusions:

  • The second wave of COVID-19 in pediatric patients was associated with more severe clinical presentations and worse outcomes compared to the first wave.
  • Healthcare providers should be aware of the changing demographic and clinical patterns of pediatric COVID-19 during different pandemic waves.

Keywords:
C-reactive proteinCOVID-19ChildrenComorbidityD-dimerFirst waveLoss of smell and tasteLow-molecular-weight heparinSecond waveSerum ferritin

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