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. 2024 Mar 1;40(3):243-248.
doi: 10.1097/PEC.0000000000003034. Epub 2023 Sep 5.

Clinical Outcomes of Children With COVID-19 by SARS-CoV-2 Strain: A Cohort Study

Lauren M Klingensmith  1 , Swati Goel  1 , Vinay N Kampalath  2 , Keri A Cohn  2
Affiliations

Clinical Outcomes of Children With COVID-19 by SARS-CoV-2 Strain: A Cohort Study

Lauren M Klingensmith et al. Pediatr Emerg Care. .

Abstract

Objective: We sought to investigate the disease outcomes and predictors of severe outcomes among children infected with the Delta variant of SARS-CoV-2 compared with pre-Delta strains.

Methods: Single-center retrospective cohort study in an emergency department located within an urban academic children's hospital. Patients included children (0-18 years) who tested positive for SARS-CoV-2. Main outcomes measured include need for hospital admission or COVID-directed therapies.

Results: There was a trend toward decreased hospital admission and no significant difference in the severity of outcomes in the Delta cohort relative to the pre-Delta cohort. The Delta cohort had lower odds of hospital admission (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.51-1.23), but the result was not statistically significant. Logistic regression analyses showed that overall, age 1 to 4 years (OR, 2.35; 95% CI, 1.23-4.57) and public insurance (OR, 1.80, 95% CI, 1.08-3.01) were predictors of hospital admission. Within the Delta cohort, the presence of any comorbidity increased the odds of admission (OR, 2.52; 95% CI, 1.09-6.04). Black children had lower odds of admission than white children (overall OR, 0.53; 95% CI, 0.31-0.90; pre-Delta OR, 0.50; 95% CI, 0.26-0.95).

Conclusions: The severity of measured disease outcomes was similar in pediatric patients when comparing children infected with the pre-Delta and Delta variants of SARS-CoV-2, even among children with comorbidities once adjusting for acuity.Ongoing research is essential to determine disease severity and risk for children with comorbidities because SARS-CoV-2 continues to mutate, including with Omicron subvariants.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

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Supplementary concepts