Retrospective Observational Study of Omicron (Sars-Cov 2 Variant) Positive Infants Aged <3 Months Admitted in Paediatric Assessment Unit (Pau)

ABSTRACT

Aims Introduction WHO designated the variant B.1.1.529, also known as Omicron, as a variant of concern in November 2021. Preliminary evidence suggests this particular variant to be highly infectious although the disease severity is relatively less as compared to Delta variant. We collated data for infants under 3 months of age who were admitted in Paediatric Assessment Unit (PAU) and tested positive for Omicron. We debate if there is a rationale of carrying out lumber puncture in such neonates especially considering this variant has been observed to be associated with milder disease. Aim The primary aim of our study was to study the clinical characteristics of < 3-month old babies admitted in PAU. The secondary aim of our retrospective review was to assess the need (and timing) of lumber puncture in this cohort. Methods We retrospectively collected data on infants under 3- months of age who were admitted in PAU from November 2021 to January 2022 and had confirmed RT-PCR test for Omicron variant of SARS CoV2. Two independent observers went through the discharge summaries to note down clinical characteristics (signs and symptoms of presentation, investigations carried out, management plan and final outcome) of these infants. We used our hospital test reporting system to confirm biochemical investigation results. Results Table 1 sums up the clinical characteristics of the 7 infants (up to 3-month of age) who were admitted to PAU (November 2021 to January 2022) and tested positive for Omicron variant 1308 Table 1 Clinical characteristics of Omicron positive neonates Abbreviation cef- Cefotaxime, Amx Amoxicillin, Neg, Negative Conclusion Summary Clinical characteristics of neonates admitted to PAU who tested positive for Omicron variant were variable and included high temperature (4 out of 7), reduced feeds (3 out of 7), mottled appearance (2 out of 7) and jaundice. Majority of these neonates received broad spectrum antibiotics for first 48-hours and they remained well since admission. The CRP in majority (5 out of 7) of these neonates was within normal range. All 7 neonates were discharged home with none requiring escalation of care. Conclusion Our retrospective observational study data suggests Omicron variant being associated with milder disease severity although it is a small single centre study with limited sample size.