SARS-CoV-2-Naïve Korean Children and Adolescents Hospitalized With COVID-19 in 2021
10.3346/jkms.2022.37.e303
- Author:
Youn Young CHOI
1
;
Soo-Han CHOI
;
Jae Hong CHOI
;
Dong Hyun KIM
;
Joon Kee LEE
;
Byung Wook EUN
;
Hyunju LEE
;
Ye Kyung KIM
;
Bin AHN
;
Seung Ha SONG
;
Ki Wook YUN
Author Information
1. Department of Pediatrics, National Medical Center, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2022;37(42):e303-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:The risk of severe outcomes with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant remains low in children and adolescents, but less is known about its effect on the SARS-CoV-2-naïve population. This study evaluated clinical manifestations and risk factors for moderate-to-critical coronavirus disease 2019 (COVID-19) in mostly SARS-CoV-2-naïve children and adolescents in 2021.
Methods:This multicenter retrospective study included patients aged 0–18 years who were hospitalized with COVID-19 at 8 referring hospitals in South Korea during the predeltapredominant and delta-predominant periods in 2021. Each case was labeled as either hospitalization with medical needs or for isolation. Severity was categorized as mild, moderate, severe, or critical with regard to pneumonia presence and illness severity.
Results:Among 753 cases, most (99.5%) had no prior history of COVID-19 or vaccination against COVID-19. The proportions of hospitalization with medical needs (3.5% vs. 19.7%), moderate illness (0.9% vs. 4.0%), and severe/critical illness (0.8% vs. 5.3%) increased during delta predominance. The risk of moderate-to-critical COVID-19 among hospitalizations with medical needs was higher among patients aged 12–18 years (adjusted odds ratio [aOR], 4.1; 95% confidence interval [CI], 1.5–11.8) and with obesity (aOR, 6.9; 95% CI, 2.4–19.6) but not among patients infected during delta predominance. However, children with obesity experienced more severe COVID-19 during delta predominance (aOR, 6.1; 95% CI, 1.2–29.6).
Conclusion:Despite its similar severity among most SARS-CoV-2-naïve children and adolescents, the delta variant may affect COVID-19 severity in those with high-risk underlying medical conditions. Underlying conditions, particularly obesity, may cause severe COVID-19 in children and adolescents, warranting strong consideration for vaccinating high-risk children.
