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Multicenter Study
. 2023 Jul 1;42(7):584-589.
doi: 10.1097/INF.0000000000003918. Epub 2023 Mar 29.

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

Maria Pokorska-Śpiewak  1 , Ewa Talarek  1 , Małgorzata Pawłowska  2 , Anna Mania  3 , Barbara Hasiec  4 , Elżbieta Żwirek-Pytka  4 , Magdalena Stankiewicz  4 , Martyna Stani  4 , Paulina Frańczak-Chmura  4 , Leszek Szenborn  5 , Izabela Zaleska  5 , Joanna Chruszcz  5 , Ewa Majda-Stanisławska  6 , Urszula Dryja  6 , Kamila Gąsiorowska  6 , Magdalena Figlerowicz  3 , Katarzyna Mazur-Melewska  3 , Kamil Faltin  3 , Przemysław Ciechanowski  7 , Michał Peregrym  7 , Joanna Łasecka-Zadrożna  7 , Józef Rudnicki  7 , Barbara Szczepańska  8 , Ilona Pałyga-Bysiecka  8 , Ewelina Rogowska  8 , Dagmara Hudobska-Nawrot  8 , Katarzyna Domańska-Granek  8 , Adam Sybilski  9   10 , Izabela Kucharek  9   10 , Justyna Franczak  2 , Małgorzata Sobolewska-Pilarczyk  2 , Ernest Kuchar  11 , Michał Wronowski  11 , Maria Paryż  12 , Bolesław Kalicki  12 , Kacper Toczyłowski  13 , Artur Sulik  13 , Sławomira Niedźwiecka  14 , Anna Gorczyca  15 , Magdalena Marczyńska  1
Affiliations
Multicenter Study

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

Maria Pokorska-Śpiewak et al. Pediatr Infect Dis J. .

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.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1.
FIGURE 1.
Comparison of the clinical presentation of COVID-19 in children hospitalized in 2020/2021. Data are presented as proportions (%) of children presenting with subsequent symptoms.
FIGURE 2.
FIGURE 2.
Proportion of children with different clinical grading of COVID-19 in 2020 and 2021.
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