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Comparison of UK paediatric SARS-CoV-2 admissions across the first and second pandemic waves.

Swann, OV; Pollock, L; Holden, KA; Munro, APS; Bennett, A; Williams, TC; Turtle, L; Fairfield, CJ; Drake, TM; Faust, SN; et al. Swann, OV; Pollock, L; Holden, KA; Munro, APS; Bennett, A; Williams, TC; Turtle, L; Fairfield, CJ; Drake, TM; Faust, SN; Sinha, IP; Roland, D; Whittaker, E; Ladhani, SN; Nguyen-Van-Tam, JS; Girvan, M; Donohue, C; Donegan, C; Spencer, RG; Hardwick, HE; Openshaw, PJM; Baillie, JK; Harrison, EM; Docherty, AB; Semple, MG; ISARIC4C Investigators (2023) Comparison of UK paediatric SARS-CoV-2 admissions across the first and second pandemic waves. Pediatr Res, 93 (1). pp. 207-216. ISSN 1530-0447 https://doi.org/10.1038/s41390-022-02052-5
SGUL Authors: Ladhani, Shamez Nizarali

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Abstract

BACKGROUND: We hypothesised that the clinical characteristics of hospitalised children and young people (CYP) with SARS-CoV-2 in the UK second wave (W2) would differ from the first wave (W1) due to the alpha variant (B.1.1.7), school reopening and relaxation of shielding. METHODS: Prospective multicentre observational cohort study of patients <19 years hospitalised in the UK with SARS-CoV-2 between 17/01/20 and 31/01/21. Clinical characteristics were compared between W1 and W2 (W1 = 17/01/20-31/07/20,W2 = 01/08/20-31/01/21). RESULTS: 2044 CYP < 19 years from 187 hospitals. 427/2044 (20.6%) with asymptomatic/incidental SARS-CoV-2 were excluded from main analysis. 16.0% (248/1548) of symptomatic CYP were admitted to critical care and 0.8% (12/1504) died. 5.6% (91/1617) of symptomatic CYP had Multisystem Inflammatory Syndrome in Children (MIS-C). After excluding CYP with MIS-C, patients in W2 had lower Paediatric Early Warning Scores (PEWS, composite vital sign score), lower antibiotic use and less respiratory and cardiovascular support than W1. The proportion of CYP admitted to critical care was unchanged. 58.0% (938/1617) of symptomatic CYP had no reported comorbidity. Patients without co-morbidities were younger (42.4%, 398/938, <1 year), had lower PEWS, shorter length of stay and less respiratory support. CONCLUSIONS: We found no evidence of increased disease severity in W2 vs W1. A large proportion of hospitalised CYP had no comorbidity. IMPACT: No evidence of increased severity of COVID-19 admissions amongst children and young people (CYP) in the second vs first wave in the UK, despite changes in variant, relaxation of shielding and return to face-to-face schooling. CYP with no comorbidities made up a significant proportion of those admitted. However, they had shorter length of stays and lower treatment requirements than CYP with comorbidities once those with MIS-C were excluded. At least 20% of CYP admitted in this cohort had asymptomatic/incidental SARS-CoV-2 infection. This paper was presented to SAGE to inform CYP vaccination policy in the UK.

Item Type: Article
Additional Information: © The Author(s) 2022 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: ISARIC4C Investigators, Pediatrics, 1114 Paediatrics and Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Pediatr Res
ISSN: 1530-0447
Language: eng
Dates:
DateEvent
January 2023Published
22 April 2022Published Online
13 December 2021Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
CO-CIN-01National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
MC_PC_19059Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
200907National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
UNSPECIFIEDDepartment for International Developmenthttp://dx.doi.org/10.13039/501100000278
215091/Z/18/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
OPP1209135Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
C18616/A25153Liverpool Experimental Cancer Medicine CentreUNSPECIFIED
PubMed ID: 35449394
Web of Science ID: WOS:000784732100001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/114369
Publisher's version: https://doi.org/10.1038/s41390-022-02052-5

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