Hospitalisations in Children with Confirmed SARS-CoV-2 Infection During December 2020 to January 2022: Retrospective Single-Centre Cohort, London, England

6 Pages Posted: 6 Apr 2022

See all articles by Borbala Zsigmond

Borbala Zsigmond

Department of Paediatric Infectious Diseases, St. George’s Hospital

Aodhán Seán Breathnach

St George's University Hospitals NHS Foundation Trust

Anna Mensah

St George’s University London - Institute for Infection and Immunity

Shamez N. Ladhani

St George's University Hospitals NHS Foundation Trust

Date Written: February 18, 2022

Abstract

Hospitalisations are often used as proxies for severe disease and to measure the impact of variants and vaccination during the COVID-19 pandemic. Unlike adults, children and young people (CYP) usually remain asymptomatic or have mild, transient infection when exposed to SARS-CoV-2. Hospitalisation for severe COVID-19 is rare in CYP but, two years into the pandemic, there are limited data on COVID-19 hospitalisations in CYP. We, therefore, undertook a retrospective case-note review of CYP admitted to a large paediatric hospital in London, England, with PCR-confirmed SARS-CoV-2 infection over a 14-month period covering the alpha, delta and omicron variant waves. During the 14-month period, there were 33,775 CYP A&E attendances and 3,593 hospitalisations at St. George’s Hospital. Of these, 147 were hospitalised with a positive SARS-CoV-2 PCR-test. Of these, only 15 (10%) were hospitalised with severe COVID-19 presenting as pneumonitis, mainly during the alpha variant wave (10/15, 67%), and in older CYP (9/15 [60%] were aged 12-18 years) with comorbidities (11/15, including 8 with immunosuppression). In a further third (49/147, 33%), SARS-CoV-2 likely contributed to hospitalisation, with had clinical presentations that were typical of other childhood viral illnesses, including fever in young infants and in immunocompromised children that required in-patient investigation and antibiotic treatment, until bacterial infections could be excluded. In the remaining 83 cases (56%), SARS-CoV-2 PCR-positivity was an incidental finding in CYP admitted for other non-infectious medical conditions. In conclusion, unlike adults, hospitalisation with a positive SARS-CoV-2 PCR-test is not a useful marker of severe COVID-19 in children. Our findings demonstrate that not only do CYP have a very low risk of hospitalisation with SARS-CoV-2 infection, but the vast majority of hospitalised CYP (especially healthy CYP) with confirmed SARS-CoV-2 infection do not have severe COVID-19, irrespective of SARS-CoV-2 variant, while the minority with severe COVID-19 recovered without complications. The very low rate of severe COVID-19 during the omicron variant wave is also reassuring.

Note:
Funding Information: None.

Conflict of Interests: None.

Ethical Approval: Anonymised patient data were used for the paper; hence ethical approval statement is not required.

Keywords: sars-cov-2, omicron variant, severe covid-19, hospitalisation, immunosupression

Suggested Citation

Zsigmond, Borbala and Breathnach, Aodhán Seán and Mensah, Anna and Ladhani, Shamez N., Hospitalisations in Children with Confirmed SARS-CoV-2 Infection During December 2020 to January 2022: Retrospective Single-Centre Cohort, London, England (February 18, 2022). Available at SSRN: https://ssrn.com/abstract=4038380 or http://dx.doi.org/10.2139/ssrn.4038380

Borbala Zsigmond (Contact Author)

Department of Paediatric Infectious Diseases, St. George’s Hospital ( email )

Blackshaw Road
London, SW17 0QT
United Kingdom

Aodhán Seán Breathnach

St George's University Hospitals NHS Foundation Trust

London
United Kingdom

Anna Mensah

St George’s University London - Institute for Infection and Immunity

London
United Kingdom

Shamez N. Ladhani

St George's University Hospitals NHS Foundation Trust

London
United Kingdom

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