Clinical Characteristics and Outcomes of Children With SARS-CoV-2 Infection During the Delta and Omicron Variant-Dominant Periods in Korea

Choi Soo-Han; Choi Jae Hong; Lee Joon Kee; Eun Byung-Wook; Song Seung Ha; Ahn Bin; Kim Ye Kyung; Yun Ki Wook

doi:10.3346/jkms.2023.38.e65

Clinical Characteristics and Outcomes of Children With SARS-CoV-2 Infection During the Delta and Omicron Variant-Dominant Periods in Korea

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Type: Academic journal

Author: Choi Soo-Han (Department of Pediatrics Pusan National University School of Medicine Busan Korea.) Choi Jae Hong (Department of Pediatrics Jeju National University School of Medicine Jeju Korea.) Lee Joon Kee (Department of Pediatrics Chungbuk National University Hospital Chungbuk National University College of Medicine Cheongju Korea.)

Journal: 대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.38 No.9 KCI Accredited Journals

Published: 2023.3

Pages: 1 - 16 (16page)

DOI: 10.3346/jkms.2023.38.e65

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Clinical Characteristics and Outcomes of Children With SARS-CoV-2 Infection During the Delta and Omicron Variant-Dominant Periods in Korea

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Background: Data on the clinical characteristics of pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant infection are limited. We aimed to evaluate the clinical features and outcomes of children with SARS-CoV-2 infection before and after omicron variant dominance in Korea. Methods: A multicenter retrospective cohort study was conducted in hospitalized patients aged ≤ 18 years with laboratory-confirmed SARS-CoV-2 infection at five university hospitals in South Korea. The study periods were divided into the delta (from August 23, 2021 to January 2, 2022) and omicron (from January 30 to March 31, 2022). Results: In total, 612 hospitalized patients were identified (211, delta; 401, omicron). During the omicron and delta periods, the proportions of individuals with serious illness (moderate, severe, and critical severity) were 21.2% and 11.8%, respectively (P = 0.034). Compared with the delta period, the proportions of patients with moderate illness increased significantly in the age groups of 0–4 years (14.2% vs. 3.4%) and 5–11 years (18.6% vs. 4.2%) during the omicron period. During the two periods, the proportions of patients with complex chronic diseases (delta, 16.0% vs. 4.3%, P = 0.040; omicron, 27.1% vs. 12.7%; P = 0.002), respiratory diseases except for asthma (delta, 8.0% vs. 0.0%, P = 0.013; omicron, 9.4% vs. 1.6%; P = 0.001), and neurologic diseases (delta, 28.0% vs. 3.2%, P < 0.001; omicron, 40.0% vs. 5.1%, P < 0.001) were significantly higher in patients with serious illness than in those with nonserious illness. During the delta period, the risk for serious illness was higher among patients with obesity (adjusted odds ratio [aOR], 8.18; 95% confidence interval [CI], 2.80–27.36) and neurologic diseases (aOR, 39.43; 95% CI, 6.90–268.3) and aged 12–18 years (aOR, 3.92; 95% CI, 1.46–10.85). However, the presence of neurologic disease (aOR, 9.80; 95% CI, 4.50–22.57) was the only risk factor for serious illness during the omicron period. During the omicron period, the proportions of patients with croup (11.0% vs. 0.5%) and seizures (13.2% vs. 2.8%) increased significantly compared with the delta period. Conclusion: Compared with the delta period, the proportions of young children and patients with complex comorbidities were higher during the omicron period in Korea. Patients with complex chronic diseases, especially neurologic diseases, had a high risk of severe coronavirus disease 2019 in the two distinct variant-dominant periods.

#COVID-19 #SARS-CoV-2 Variants #SARS-CoV-2 Omicron Variant #SARS-CoV-2 Delta Variant #Child #Adolescent

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Choi Soo-Han

Affiliation Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.Biomedical Research Institute, Pusan National University Hospital, Bu