Department of Pediatrics, Hospital Tuanku Ja'afar, Seremban, Malaysia.
Ministry of Health Malaysia, Kuala Pilah, Malaysia.
Pediatr Int. 2024 Jan-Dec;66(1):e15777. doi: 10.1111/ped.15777.
We aimed to compare the clinical features and severity of the Omicron and Delta variant infections among children hospitalized for coronavirus disease 2019 (COVID-19).
Children 12 years old or less hospitalized for COVID-19 across five hospitals between January 1, 2021 and March 31, 2022 were identified using the state's pediatric COVID-19 registry. Delta and Omicron-infected patients without previous COVID-19 infection, COVID-19 vaccination, or co-infections were propensity-score matched 1:1 to control for differences in baseline characteristics. Clinical manifestations, treatments, and outcomes were analyzed. Disease severity was assessed using an adapted WHO ordinal scale.
Of the initial 1367 patients, 668 had Delta infection and 699 had Omicron infection. Propensity-score matching produced 558 matched pairs. Patients with Omicron infection were more likely to present with croup (the odds ratio, OR, was 10.87, with a 95% confidence interval, CI, ranging from 2.54 to 46.59), lower respiratory tract infection (OR 2.32, 95% CI, 1.48-3.64) and seizures (OR 8.39, 95% CI, 5.04-13.99) compared with those with Delta infection. Omicron was associated with increased odds of moderate/severe disease (OR 6.14, 95% CI, 4.72-7.99) and a greater need for intravenous fluid therapy (OR 6.00, 95% CI, 4.29-8.39), corticosteroids (OR 3.08, 95% CI, 1.66-5.72), empirical antibiotics (OR 1.70, 95% CI, 1.10-2.64), and low-flow nasal oxygen therapy (OR 3.68, 95% CI, 2.17-6.22) in comparison with Delta.
Children hospitalized with Omicron infection demonstrated a distinct clinical profile compared to those with Delta infection, with increased likelihood of moderate/severe disease and higher utilization of health-care resources.
我们旨在比较奥密克戎和德尔塔变异株感染导致儿童住院的临床特征和严重程度。
使用该州的儿科 COVID-19 登记处，确定 2021 年 1 月 1 日至 2022 年 3 月 31 日期间在五家医院因 COVID-19 住院的 12 岁或以下的儿童。未患有先前 COVID-19 感染、COVID-19 疫苗接种或合并感染的德尔塔和奥密克戎感染患者通过倾向评分匹配以 1:1 的比例进行匹配，以控制基线特征的差异。分析临床表现、治疗和结局。使用改良的世卫组织等级量表评估疾病严重程度。
在最初的 1367 名患者中，668 名患有德尔塔感染，699 名患有奥密克戎感染。通过倾向评分匹配产生了 558 对匹配对。奥密克戎感染患者更有可能出现哮吼（优势比 [OR] 为 10.87，95%置信区间 [CI] 为 2.54 至 46.59）、下呼吸道感染（OR 2.32，95%CI，1.48-3.64）和癫痫发作（OR 8.39，95%CI，5.04-13.99）。与德尔塔感染相比，奥密克戎感染与中度/重度疾病的几率增加（OR 6.14，95%CI，4.72-7.99）和更需要静脉补液治疗（OR 6.00，95%CI，4.29-8.39）、皮质类固醇（OR 3.08，95%CI，1.66-5.72）、经验性抗生素（OR 1.70，95%CI，1.10-2.64）和低流量鼻氧疗（OR 3.68，95%CI，2.17-6.22）相关。
与德尔塔感染相比，因奥密克戎感染住院的儿童表现出明显不同的临床特征，中度/重度疾病的可能性更高，并且对医疗资源的利用更高。
