Age-Varying Susceptibility to the Delta Variant (B.1.617.2) of SARS-CoV-2

Abstract

IMPORTANCEThe Delta variant (B.1.617.2) is estimated to be more transmissible than previous strains of SARS-CoV-2, especially among children and adolescents. However, to our knowledge, there are no reports confirming this to date. OBJECTIVETo gain a better understanding of the association of age with susceptibility to the Delta variant of SARS-CoV-2. DESIGN, SETTING, AND PARTICIPANTS This decision analytic model used an age-structured compartmental model using the terms symptom onset (S), exposure (E), infectious (I), and quarantine (Q) (SEIQ) to estimate the age-specific force of infection, combining age-specific contact matrices and observed distribution of periods between each stage of infection (E to I [ie, latent period], I given S, and S to Q [ie, diagnostic delay]) developed in a previous contact tracing study. A bayesian inference method was used to estimate the age-specific force of infection (S to E) and, accordingly, age-specific susceptibility. The age-specific susceptibility during the third wave (ie, before Delta, from October 15 to December 22, 2020, when the COVID-19 vaccination campaign was not yet launched) and the fourth wave (ie, the Delta-driven wave, from June 27 to August 21, 2021) in Korea were compared. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta variant. This nationwide epidemiologic study included individuals who were diagnosed with COVID-19 during the study period in Korea. Data were analyzed from September to November 2021. EXPOSURES Age group during the third wave (ie, before Delta) and fourth wave (ie, Delta-driven) of the COVID-19 pandemic in South Korea. MAIN OUTCOMES AND MEASURES Age-specific susceptibility during the third and fourth waves was estimated. RESULTS Among 106 866 confirmed COVID-19 infections (including 26 597 infections and 80 269 infections during the third and fourth waves of COVID-19 in Korea, respectively), a significant difference in age-specific susceptibility to the Delta vs pre-Delta variant was found in the younger age group. After adjustment for contact pattern and vaccination status, the increase in susceptibility to the Delta vs pre-Delta variant was estimated to be highest in the group aged 10 to 15 years, approximately doubling (1.92-fold increase [95% CI, 1.86-fold to 1.98-fold]), whereas in the group aged 50 years or more, susceptibility to the Delta vs pre-Delta variant remained stable at an approximately 1-fold change (eg, among individuals aged 50-55 years: 0.997-fold [95% CI, 0.989fold to 1.001-fold). CONCLUSIONS AND RELEVANCEIn this study, the Delta variant of SARS-CoV-2 was estimated to propagate more easily among children and adolescents than pre-Delta strains, even after adjusting for contact pattern and vaccination status.

Identifying susceptibility of children and adolescents to the Omicron variant (B.1.1.529)

“…We adapted a previously described model which estimated the age-varying susceptibility to the Delta variant [ 9 ] and updated the model with recent vaccine coverage data and waning of vaccine effectiveness against the Omicron infection.…”

“…Following our previous study, we built an age-structured compartmental model stratified into 5-year age bands [ 9 ]. Compartments in the model were stratified by infection states (i.e., susceptible [ S ], exposed [ E ], infectious and pre-symptomatic [ Ipresym ], infectious and symptomatic [ Isym ], infectious and asymptomatic [ Iasym ], or quarantined [ Q ]), age band, and the transition time to the next infection state (Additional file 1 : eMethods).…”

Traditional Chinese Medicine in Treating Children With Coronavirus Disease 2019: A Scoping Review

“…(1) random sequence generation, (2) attrition bias, (3) allocation concealments, (4) blinding of participants and personnel, (5) blinding of outcome assessment, (6) incomplete outcome data, (7) selective outcome reporting, and (8) other biases. Each potential source of bias was graded as high, low, or unclear, providing a quote from the study report and a justification of our judgment in the "risk of bias" table.…”

“…It has also been shown that long-term humoral immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children last longer even after asymptomatic infection than in adults (2). At present, the emergence of SARS-CoV-2 variants has caused the increasing prevalence in children around the world (3)(4)(5)(6). More research is urgently needed on the long-term relationship between COVID-19 and children (7).…”

Age-varying susceptibility to the Omicron variant (B.1.1.529) of SARS-CoV-2

“…5 Since we know the age-strati ed incidence of COVID-19 at discrete time, transition time distribution to the next infection stage, and the age-speci c contact matrix for South Korea, we could infer the age-speci c susceptibility using Bayesian inference method (see Methods). [6][7][8][9] More precisely, we removed individuals who were vaccinated from the susceptible population in accordance with the vaccine effectiveness against the Delta and the Omicron variants. 10 The waning of vaccine effectiveness was also considered.…”