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. 2022 Apr 1:10:810404.
doi: 10.3389/fped.2022.810404. eCollection 2022.

Clinical Epidemiology of Pediatric COVID-19 Delta Variant Cases From North Sumatra, Indonesia

R Lia Kusumawati  1   2 , Inke Nadia Diniyanti Lubis  3 , Meutia Ayuputeri Kumaheri  4 , Ariel Pradipta  4 , Kiatichai Faksri  5   6 , Mutiara Mutiara  2 , Anuraj H Shankar  4   7   8 , Tryna Tania  2
Affiliations

Clinical Epidemiology of Pediatric COVID-19 Delta Variant Cases From North Sumatra, Indonesia

R Lia Kusumawati et al. Front Pediatr. .

Abstract

The Delta variant of SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) dominated the coronavirus disease 2019 (COVID-19) pandemic in 2021. Here we report the Delta variant among pediatric cases in North Sumatra, Indonesia, from June to July 2021. Whole-genome sequencing (WGS) from 18 new COVID-19 pediatric patients showed that six were B.1.459 and six were B.1.466.2, known variants in Indonesia in clade 20A. Six were the Delta variant B.1.617.2 of clade 21A, with five on one branch and one on a distant branch consistent with that patient's geographic separation, suggesting at least two introductions to the region. Variants tended to be spatially clustered, and four children with Delta variant had an adult infected household member, all of whom had lower real-time polymerase chain reaction cycle threshold (Ct) values compared with the child. No temporal trends were observed for Ct. These data support a paradigm shift with children being highly susceptible to the Delta variant and a priority for vaccination.

Keywords: COVID-19; SARS-CoV-2; children; infection; pandemic.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Phylogenetic tree built with Nextclade v1.5.4. (A) Highlighted 18 viruses as reported in Table 2. (B) Focused view of where the 6 Delta variants are located under the 21A clade (Delta variants). (C) Focused view of the other 12 viruses under clade 20A.
Figure 3
Figure 3
Temporal pattern of variants among 18 children with COVID-19 in North Sumatra, Indonesia. (X axis: date of detection (d/m/y); Y axis: number of cases).
Figure 4
Figure 4
Distribution of SARS-CoV-2 variants by area of origin within or outside medan municipality. Figure legend: B.1.459 (blue); B.1.466.2 (orange); B.1.617.2 (green).
Figure 5
Figure 5
New pediatric COVID-19 cases and positivity rate from January to July 2021 at Murni Teguh Memorial Hospital.
Figure 6
Figure 6
New COVID-19 paediatric cases by age group (in year) from January to July 2021 at Murni Teguh Memorial Hospital, Medan. Line graph indicates number for pediatric COVID-19 cases with hospitalization and death from January to July 2021 at Murni Teguh Memorial Hospital, Medan.
Figure 7
Figure 7
(A) Mean Ct values of paediatric patients for ORF or RdRP target genes low (10.65 to <20.39); moderate (20.39 to <30.13); high (30.13 to 39.88). (B) Mean Ct values of paediatric patients for the N target gene low (9.31 to <19.53); moderate (19.53 to <29.74); high (29.74 to 39.96).
See this image and copyright information in PMC

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