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

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 te...

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Main Authors: Patrick O. Kenney, Arthur J. Chang, Lorna Krabill, Mark D. Hicar
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Viruses
Subjects:
Online Access:https://www.mdpi.com/1999-4915/15/1/180
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author Patrick O. Kenney
Arthur J. Chang
Lorna Krabill
Mark D. Hicar
author_facet Patrick O. Kenney
Arthur J. Chang
Lorna Krabill
Mark D. Hicar
author_sort Patrick O. Kenney
collection DOAJ
description 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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spelling doaj.art-c767068ae8a340bbae15af624316c6b42023-12-01T01:12:11ZengMDPI AGViruses1999-49152023-01-0115118010.3390/v15010180Decreased Clinical Severity of Pediatric Acute COVID-19 and MIS-C and Increase of Incidental Cases during the Omicron Wave in Comparison to the Delta WavePatrick O. Kenney0Arthur J. Chang1Lorna Krabill2Mark D. Hicar3Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USAChildren’s Hospital & Medical Center, Omaha, NE 68114, USAJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USAJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USAThis 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.https://www.mdpi.com/1999-4915/15/1/180COVID-19MIS-Cpediatric hospitalizations
spellingShingle Patrick O. Kenney
Arthur J. Chang
Lorna Krabill
Mark D. Hicar
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
Viruses
COVID-19
MIS-C
pediatric hospitalizations
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic COVID-19
MIS-C
pediatric hospitalizations
url https://www.mdpi.com/1999-4915/15/1/180
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