Study Data Suggest SARS-CoV-2 Is Less Severe in Pediatric Patients

The SARS-CoV-2 infection poses a risk for individuals of all ages, although the likelihood of severe COVID-19 infection is higher in individuals aged 65 years or older, those staying in nursing homes or long-term care facilities, those who are unvaccinated against COVID-19 or who had poor responses to COVID-19 vaccines, and those with certain chronic medical conditions.¹ According to COVID-19 treatment guidelines from the National Institutes of Health, data on SARS-CoV-2 infection pathogenesis and clinical spectrum in children remain sparse compared with the data for adults.

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A group of investigators conducted a retrospective cohort study in Italy comparing SARS-CoV-2 infection with other viral respiratory tract infections (RTIs) in 2 pediatric settings.² The study evaluated the relationship between viral respiratory pathogens and illness course and compared hospitalization, length of hospital admission, respiratory support requirement, antibiotic use, or clinical complications.

The study cohort consisted of all viral RTIs in children aged 0 to 15 years who were discharged from the pediatric emergency department or admitted to the pediatric acute care unit. Pediatric viral RTIs in this study included influenza, respiratory syncytial virus (RSV), adenovirus, rhinovirus, metapneumovirus, other coronaviruses, and SARS-CoV-2 infections. The investigators included study participants with microbiologically confirmed viral RTIs who were either discharged or admitted between November 2018 and April 2019 (historical period) and March 2020 and April 2021 (recent period).²

The investigators identified 767 viral RTIs overall during the historical period in the study cohort, which included a subset of 408 SARS-CoV-2 infections for comparison.² The results showed that pediatric patients with SARS-CoV-2 infections had a lower risk of admission, need for respiratory support, need for antibiotic therapy, and developing complications compared with all other viral RTIs.²

Study limitations included wide confidence intervals and lack of data collection for Delta and Omicron SARS-CoV-2 variants that spread in Italy after May 2021.²

The investigators noted that COVID-19 in infants is associated with a less severe infectious course compared with other viral RTIs. Regardless, hygiene practices and prevention measures for SARS-CoV-2 should be strongly practiced during RSV, influenza, and adenovirus epidemics, especially for morbidity reduction in infants and children.

References

1. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. Accessed March 16, 2024.

2. Brigadoi G, Demarin GC, Boracchini R, et al. Comparison between the Viral Illness Caused by SARS-CoV-2, Influenza Virus, Respiratory Syncytial Virus and Other Respiratory Viruses in Pediatrics. Viruses. 2024;16(2):199. Published 2024 Jan 27.