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

Autor: Swann OV; Department of Child Life and Health, University of Edinburgh, Edinburgh, UK.; Paediatric Infectious Diseases, Royal Hospital for Children, Glasgow, UK., Pollock L; Paediatric Infectious Diseases, Royal Hospital for Children, Glasgow, UK.; Child Health, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK., Holden KA; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK.; Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK., Munro APS; NIHR Southampton Clinical Research Facility and NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK., Bennett A; Institute of Infection and Immunity, St George's, University of London, London, UK., Williams TC; Department of Child Life and Health, University of Edinburgh, Edinburgh, UK., Turtle L; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK.; Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, UK., Fairfield CJ; Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK., Drake TM; Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK., Faust SN; NIHR Southampton Clinical Research Facility and NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK., Sinha IP; Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.; Women's and Children's Health, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK., Roland D; Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, University Hospitals of Leicester NHS Trust, Leicester, UK.; SAPPHIRE Group, Health Sciences, Leicester University, Leicester, UK., Whittaker E; Section of Paediatric Infectious Diseases, Imperial College London, London, UK.; Paediatric Infectious Diseases, Imperial College Healthcare National Health System Trust, London, UK., Ladhani SN; Immunisation and Countermeasures Division, Public Health England Colindale, London, UK.; Paediatric Infectious Disease, St. George's Hospital London, London, UK., Nguyen-Van-Tam JS; Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK., Girvan M; Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK., Donohue C; Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK., Donegan C; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK., Spencer RG; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK., Hardwick HE; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK., Openshaw PJM; National Heart and Lung Institute, Imperial College London, London, UK., Baillie JK; Roslin Institute, University of Edinburgh, Edinburgh, UK.; Intensive Care Unit, Royal Infirmary Edinburgh, Edinburgh, UK., Harrison EM; Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK., Docherty AB; Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.; Intensive Care Unit, Royal Infirmary Edinburgh, Edinburgh, UK., Semple MG; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK. m.g.semple@liverpool.ac.uk.; Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK. m.g.semple@liverpool.ac.uk.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2023 Jan; Vol. 93 (1), pp. 207-216. Date of Electronic Publication: 2022 Apr 22.
DOI: 10.1038/s41390-022-02052-5
Abstrakt: 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.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz: