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. 2025 Jan 7:12:1440107.
doi: 10.3389/fped.2024.1440107. eCollection 2024.

Epidemiological characterization of COVID-19 in children under 18 years old in Mexico: an analysis of the pandemic

Isamu Daniel Takane-Cabrera  1 , Fanny Yasmin Ortega-Vargas  1 , Ilen Adriana Díaz-Torres  1 , Aldo Agustin Herrera-González  1 , Antonio R Villa  1 , Miguel Leonardo García-León  1 , Patricia Bautista-Carbajal  1 , Miguel A Pérez-Sastre  2 , Luis Alberto Cortazar-Maldonado  1 , Jorge Baruch Díaz-Ramírez  2 , Rosa Maria Wong-Chew  1
Affiliations

Epidemiological characterization of COVID-19 in children under 18 years old in Mexico: an analysis of the pandemic

Isamu Daniel Takane-Cabrera et al. Front Pediatr. .

Abstract

Objective: The study aimed to describe the characteristics and risk factors associated with disease severity across six waves of COVID-19 in the pediatric population in Mexico.

Methods: A cohort study was conducted using data from the Mexican Ministry of Health, covering the period from March 2020 to March 2023. The dataset included patients under 18 years of age with confirmed SARS-CoV-2 infection. Univariate, bivariate, and logistic regression analyses were performed to determine demographic and clinical characteristics, mortality across waves, and age group distributions.

Results: Of the total cohort, 9.5% were children, with 497,428 confirmed cases. Among these, 50% were male, 4.4% required hospitalization, and there were 1,447 (0.03%) deaths. The highest prevalence was observed in the 12-17-year age group (52%), followed by the 5-11-year age group (32%), with incidence rates peaking towards the end of 2021 and the early 2022. Although the 0-2-year age group represented 9.6% of cases, it had higher hospitalization (40%), ICU admission (58%), and case fatality rate (CFR) (44%). Cardiovascular disease, hypertension, diabetes and immunosuppression were identified as risk factors for severe outcomes. The initial wave displayed the highest CFR (OR 5.28) especially in children aged 0-2 years.

Conclusions: Children were less affected during the pandemic compared to adults; however, children under two years-old experienced more severe outcomes. Currently, with 95% of the population estimated to be immune due to vaccination and/or prior infection, children under 2 years of age are now at higher risk of severe disease and should be evaluated for vaccination as a public health policy.

Keywords: COVID-19; Mexico; SARS-CoV-2; children; incidence; mortality; pandemic; waves.

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Conflict of interest statement

JD-R is a member of the Becton Dickinson, Merck Sharp & Dohme and Sanofi Pasteur speaker’s bureau and served on the advisory board for Sanofi Pasteur. RW-C is a member of the Seegene, Reckitt, Asofarma, AstraZeneca and Sanofi Pasteur speaker’s bureau and served on the advisory board for Sanofi Pasteur, Asofarma and AstraZeneca. The remaining 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
Flowchart of patients included in the study.
Figure 2
Figure 2
COVID-19 variants in Mexico. Downloaded from https://nextstrain.org/ncov/gisaid/global/all-time?f_country=Mexico under the The CC-BY-4.0 (accessed on September, 2024).
Figure 3
Figure 3
Distribution of pediatric COVID-19 cases by state.
Figure 4
Figure 4
Incidence of COVID-19 cases and deaths in Mexican children during the SARS-CoV2 pandemic. The figure shows the semiannual distribution of the incidence (A) and mortality rate (B) of SARS-CoV-2 cases per 100,000 children under 18 years of age, from 2020 to 2023, categorized by age groups in Mexican children with COVID-19. The first semester of 2023 includes only from January to March 2023. The incidence and mortality rate are cases per 100,000 children.
Figure 5
Figure 5
Number of deaths in the pediatric population in Mexico during the COVID-19 pandemic. The graph illustrates the number of deaths per month and per year, with the highest monthly peaks occurring during the predominance of the Delta and Omicron waves.
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