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Comparison of UK paediatric SARS-CoV-2 admissions across the first and second pandemic waves.
Swann, Olivia V; Pollock, Louisa; Holden, Karl A; Munro, Alasdair P S; Bennett, Aisleen; Williams, Thomas C; Turtle, Lance; Fairfield, Cameron J; Drake, Thomas M; Faust, Saul N; Sinha, Ian P; Roland, Damian; Whittaker, Elizabeth; Ladhani, Shamez N; Nguyen-Van-Tam, Jonathan S; Girvan, Michelle; Donohue, Chloe; Donegan, Cara; Spencer, Rebecca G; Hardwick, Hayley E; Openshaw, Peter J M; Baillie, J Kenneth; Harrison, Ewen M; Docherty, Annemarie B; Semple, Malcolm G.
  • Swann OV; Department of Child Life and Health, University of Edinburgh, Edinburgh, UK.
  • Pollock L; Paediatric Infectious Diseases, Royal Hospital for Children, Glasgow, UK.
  • Holden KA; Paediatric Infectious Diseases, Royal Hospital for Children, Glasgow, UK.
  • Munro APS; Child Health, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK.
  • Bennett A; 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.
  • Williams TC; Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
  • Turtle L; NIHR Southampton Clinical Research Facility and NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Fairfield CJ; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
  • Drake TM; Institute of Infection and Immunity, St George's, University of London, London, UK.
  • Faust SN; Department of Child Life and Health, University of Edinburgh, Edinburgh, UK.
  • Sinha IP; 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.
  • Roland D; Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, UK.
  • Whittaker E; Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Ladhani SN; Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Nguyen-Van-Tam JS; NIHR Southampton Clinical Research Facility and NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Girvan M; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
  • Donohue C; Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
  • Donegan C; Women's and Children's Health, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
  • Spencer RG; Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
  • Hardwick HE; SAPPHIRE Group, Health Sciences, Leicester University, Leicester, UK.
  • Openshaw PJM; Section of Paediatric Infectious Diseases, Imperial College London, London, UK.
  • Baillie JK; Paediatric Infectious Diseases, Imperial College Healthcare National Health System Trust, London, UK.
  • Harrison EM; Immunisation and Countermeasures Division, Public Health England Colindale, London, UK.
  • Docherty AB; Paediatric Infectious Disease, St. George's Hospital London, London, UK.
  • Semple MG; Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK.
Pediatr Res ; 2022 Apr 22.
Article in English | MEDLINE | ID: covidwho-1805591
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.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Year: 2022 Document Type: Article Affiliation country: S41390-022-02052-5

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Year: 2022 Document Type: Article Affiliation country: S41390-022-02052-5