Incidence and Clinical Characteristics of Severe Acute Respiratory Syndrome Coronavirus 2 Infection After Vaccination in Children

Reyna, Megan E.; Edward, Priya R.; Ozer, Egon A.; Simons, Lacy M.; Hultquist, Judd F.; Lorenzo-Redondo, Ramón; Patel, Ami B; Kociolek, Larry K.

doi:10.1016/j.jpeds.2022.07.056

Cited by 1 publication

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References 16 publications

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“…Some small cohort studies suggest that the phenotypes are similar [ 11 ], however one study showed a trend to shorter length of stays [ 9 ], and another study supported less vasopressor use and ICU utilization [ 10 ]. Vaccination is protective against developing MIS-C in pre-Omicron studies [ 12 ] and seems to continue to protect children during Omicron from severe disease and hospitalization [ 13 ]. As vaccine usage in children 5–11 years of age was not available until midway into the Delta wave in November of 2021 [ 14 ], further analysis of vaccine protection is warranted.…”

Section: Introductionmentioning

confidence: 99%

Decreased Clinical Severity of Pediatric Acute COVID-19 and MIS-C and Increase of Incidental Cases during the Omicron Wave in Comparison to the Delta Wave

Kenney

Chang

Krabill³

et al. 2023

Viruses

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This study describes differences in clinical presentation in hospitalized children with acute COVID-19 and MIS-C between the Delta and Omicron (BA.1.1) waves in a tertiary children’s hospital. This retrospective cohort study with case adjudication of hospitalized children with SARS-CoV-2-positive testing or MIS-C diagnosis occurred during the Delta and Omicron waves, from August 2021 until February 2022. There were no differences noted by race, but both waves disproportionally affected black children (24% and 25%). Assigned by a three-person expert panel, incidental diagnoses were higher in the Omicron wave (34% versus 19%). Hospitalization rates of non-incidental cases were higher during Omicron (3.8 versus 5.9 per 1000 PCR-positive community cases). Respiratory-related admissions were prominent during Delta, while Omicron clinical presentations varied, including a high number of cases of croup and seizures. Length of stay and ICU use during Omicron was significantly less than Delta for MIS-C and acute cases. Estimation of vaccination efficacy for preventing hospital admissions was 85.1–91.7% in the early Omicron period. Our estimates suggest that a protective role for vaccination continues into the Omicron wave. The high rate of incidental cases during the Omicron wave should be considered when reviewing more cursory summative data sets. This study emphasizes the need for continued clinical suspicion of COVID-19 even when lower respiratory symptoms are not dominant.

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