Epidemiological characterization of SARS-CoV-2 variants in children over the four COVID-19 waves and correlation with clinical presentation

Alteri, Claudia; Scutari, Rossana; Costabile, Valentino; Colagrossi, Luna; Rosa, Katia Yu La; Agolini, Emanuele; Lanari, Valentina; Chiurchiù, Sara; Romani, Lorenza; Markowich, Anna Hermine; Bernaschi, Paola; Russo, Cristina; Novelli, Antonio; Bernardi, Stefania; Campaña, Andrea; Villani, Alberto; Perno, Carlo Federico

doi:10.1038/s41598-022-14426-0

Cited by 21 publications

(25 citation statements)

References 45 publications

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“…Despite the low risk, the asymptomatic group with a high SARS-CoV-2 viral load may play a significant role in community-based viral transmission. On the contrary, patients aged < 5 years were characterized by a higher SARS-CoV-2 viral load in the nasopharynx than the adolescent population [ 42 ]. However, in this study, we did not find a significant difference in SARS-CoV-2 viral load in all age groups.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Coronavirus Disease (COVID-19) in Mexican Children and Adolescents

Flores-Alanis

Saldaña-Ahuactzi

Parra-Ortega

et al. 2022

Viruses

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Background: We analyzed the demographic, clinical, and diagnostic data of children and adolescents in Mexico, from the first case of coronavirus disease (COVID-19) to 28 February 2022. Methods: Using the open databases of the Ministry of Health and a tertiary pediatric hospital, we obtained demographic and clinical data from the beginning of the COVID-19 pandemic until 28 February 2022. In addition, quantitative reverse-transcription polymerase chain reaction outputs were used to determine the viral load, and structural protein-based serology was performed to evaluate IgG antibody levels. Results: Of the total 437,832 children and adolescents with COVID-19, 1187 died. Of these patients, 1349 were admitted to the Hospital Infantil de Mexico Federico Gómez, and 11 died. Obesity, asthma, and immunosuppression were the main comorbidities, and fever, cough, and headache were the main symptoms. In this population, many patients have a low viral load and IgG antibody levels. Conclusion: During the first 2 years of the COVID-19 pandemic in Mexico, children and adolescents had low incidence and mortality. They are a heterogeneous population, but many patients had comorbidities such as obesity, asthma, and immunosuppression; symptoms such as fever, cough, and headache; and low viral load and IgG antibodies.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Coronavirus Disease (COVID-19) in Mexican Children and Adolescents

Flores-Alanis

Saldaña-Ahuactzi

Parra-Ortega

et al. 2022

Viruses

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“…They revealed that age <5 years, the highest viral load, and gamma and delta clades positively influence this local transmission. No correlations between COVID-19 manifestations and lineages or transmission chains are seen, except for a negative correlation between B.1.1.7 and hospitalization [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Course and Severity of COVID-19 in 940 Infants with and without Comorbidities Hospitalized in 2020 and 2021: The Results of the National Multicenter Database SARSTer-PED

Pawlowska

Pokorska‐Śpiewak

Talarek

et al. 2023

JCM

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This study aimed to analyze the differences in severity and clinical characteristics of COVID-19 in infants hospitalized in Poland in 2021, when the dominance of variants of concern (VOCs) alpha and delta was reported, compared to 2020, when original (wild) SARS-CoV-2 was dominant (III–IV vs. I–II waves of the pandemic, respectively). In addition, the influence of the presence of comorbidities on the clinical course of COVID-19 in infants was studied. This multicenter study, based on the pediatric part of the national SARSTer database (SARSTer-PED), included 940 infants with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 13 Polish inpatient centers. An electronic questionnaire, which addressed epidemiological and clinical data, was used. The number of hospitalized infants was significantly higher in 2021 than in 2020 (651 vs. 289, respectively). The analysis showed similar lengths of infant hospitalization in 2020 and 2021, but significantly more children were hospitalized for more than 7 days in 2020 (p < 0.009). In both analyzed periods, the most common route of infection for infants was household contact. There was an increase in the percentage of comorbidities, especially prematurity, in children hospitalized in 2021 compared to 2020. Among the clinical manifestations, fever was predominant among children hospitalized in 2021 and 2020. Cough, runny nose, and loss of appetite were significantly more frequently observed in 2021 (p < 0.0001). Severe and critical conditions were significantly more common among children with comorbidities. More infants were hospitalized during the period of VOCs dominance, especially the delta variant, compared to the period of wild strain dominance, even though indications for hospitalization did not include asymptomatic patients during that period. The course of COVID-19 was mostly mild, characterized mainly by fever and respiratory symptoms. Comorbidities, particularly from the cardiovascular system and prematurity, were associated with a more severe course of the disease in infants.

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“…Children have been less likely to be infected and develop severe disease by the original SARS-CoV-2 (Wuhan) strain compared to adults 1 – 3 . However, the combination of increased transmissibility of SARS-CoV-2 Delta and Omicron variants, increased population movement due to the easing of COVID-19 restrictions, and a higher vaccination rate in adults compared with children have resulted in rising COVID-19 cases among children 4 , 5 . Despite this, SARS-CoV-2 infections in children are mostly mild or asymptomatic.…”

Section: Introductionmentioning

confidence: 99%

Comparison of antibody responses to SARS-CoV-2 variants in Australian children

et al. 2022

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There is limited understanding of antibody responses in children across different SARS-CoV-2 variants. As part of an ongoing household cohort study, we assessed the antibody response among unvaccinated children infected with Wuhan, Delta, or Omicron variants, as well as vaccinated children with breakthrough Omicron infection, using a SARS-CoV-2 S1-specific IgG assay and surrogate virus neutralization test (% inhibition). Most children infected with Delta (100%, 35/35) or Omicron (81.3%, 13/16) variants seroconverted by one month following infection. In contrast, 37.5% (21/56) children infected with Wuhan seroconverted, as previously reported. However, Omicron-infected children (geometric mean concentration 46.4 binding antibody units/ml; % inhibition = 16.3%) mounted a significantly lower antibody response than Delta (435.5 binding antibody untis/mL, % inhibition = 76.9%) or Wuhan (359.0 binding antibody units/mL, % inhibition = 74.0%). Vaccinated children with breakthrough Omicron infection mounted the highest antibody response (2856 binding antibody units/mL, % inhibition = 96.5%). Our findings suggest that despite a high seropositivity rate, Omicron infection in children results in lower antibody levels and function compared with Wuhan or Delta infection or with vaccinated children with breakthrough Omicron infection. Our data have important implications for public health measures and vaccination strategies to protect children.

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Epidemiological characterization of SARS-CoV-2 variants in children over the four COVID-19 waves and correlation with clinical presentation

Cited by 21 publications

References 45 publications

Clinical Characteristics of Coronavirus Disease (COVID-19) in Mexican Children and Adolescents

Clinical Characteristics of Coronavirus Disease (COVID-19) in Mexican Children and Adolescents

Clinical Course and Severity of COVID-19 in 940 Infants with and without Comorbidities Hospitalized in 2020 and 2021: The Results of the National Multicenter Database SARSTer-PED

Comparison of antibody responses to SARS-CoV-2 variants in Australian children

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