The Influence of SARS-CoV-2 Variants B.1.1.7 and B.1.617.2 on a Different Clinical Course and Severity of COVID-19 in Children Hospitalized in 2021 Compared With 2020

Author:

Pokorska-Śpiewak Maria1ORCID,Talarek Ewa1,Pawłowska Małgorzata2,Mania Anna3,Hasiec Barbara4,Żwirek-Pytka Elżbieta4,Stankiewicz Magdalena4,Stani Martyna4,Frańczak-Chmura Paulina4,Szenborn Leszek5,Zaleska Izabela5,Chruszcz Joanna5,Majda-Stanisławska Ewa6,Dryja Urszula6,Gąsiorowska Kamila6,Figlerowicz Magdalena3,Mazur-Melewska Katarzyna3,Faltin Kamil3,Ciechanowski Przemysław7,Peregrym Michał7,Łasecka-Zadrożna Joanna7,Rudnicki Józef7,Szczepańska Barbara8,Pałyga-Bysiecka Ilona8,Rogowska Ewelina8,Hudobska-Nawrot Dagmara8,Domańska-Granek Katarzyna8,Sybilski Adam910,Kucharek Izabela910,Franczak Justyna2,Sobolewska-Pilarczyk Małgorzata2,Kuchar Ernest11,Wronowski Michał11,Paryż Maria12,Kalicki Bolesław12,Toczyłowski Kacper13,Sulik Artur13,Niedźwiecka Sławomira14,Gorczyca Anna15,Marczyńska Magdalena1

Affiliation:

1. Department of Children’s Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw

2. Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz

3. Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences

4. Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin

5. Department of Pediatrics and Infectious Diseases, Wroclaw Medical University

6. Department of Pediatric Infectious Diseases, Medical University of Lodz

7. Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin

8. Collegium Medicum Jan Kochanowski University, Kielce

9. 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw

10. Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw

11. Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw

12. Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw

13. Department of Pediatric Infectious Diseases, Medical University of Bialystok

14. Department of Pediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk

15. The Ward of Pediatric Infectious Diseases and Hepatology, The John Paul II Hospital in Krakow

Abstract

Background: This study aimed to analyze the differences in the epidemiologic and clinical characteristics of coronavirus disease 2019 (COVID-19) in children hospitalized in 2021, when the severe acute respiratory syndrome coronavirus 2 variants B.1.1.7 (alpha) and B.1.617.2 (delta) dominated, compared with 2020. Methods: In this multicenter study based on the pediatric part of the national SARSTer register (SARSTer-PED), we included 2771 children (0–18 years) with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 14 Polish inpatient centers. An electronic questionnaire, which addressed epidemiologic and clinical data, was used. Results: Children hospitalized in 2021 were younger compared with those reported in 2020 (mean 4.1 vs. 6.8 years, P = 0.01). Underlying comorbidities were reported in 22% of the patients. The clinical course was usually mild (70%). A significant difference in the clinical course assessment between 2020 and 2021 was found, with more asymptomatic patients in 2020 and more severely ill children in 2021. In total, 5% of patients were severely or critically ill, including <3% of the participants in 2020 and 7% in 2021. The calculated mortality rate was 0.1% in general and 0.2% in 2021. Conclusion: Infections with severe acute respiratory syndrome coronavirus 2 variants alpha and delta lead to a more severe course of COVID-19 with more pronounced clinical presentation and higher fatality rates than infection with an original strain. Most of the children requiring hospitalization due to COVID-19 do not have underlying comorbidities.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Infectious Diseases,Microbiology (medical),Pediatrics, Perinatology and Child Health

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