COVID-19 in children under 5 years old with Omicron is mild compared to the Delta variant

What are the outcomes for children under five years old who have Omicron? That’s the purpose of the study released yesterday from Case Western Reserve University. How many went to the emergency room? How many got hospitalized? And how many needed intensive care treatment and required mechanical ventilation for respiratory support.

The study compared two groups of children who had a first-time COVID-19 infection depending on which variant was predominant when they got sick.

7,201 children under five years old who were infected with the Omicron variant between 12/26/2021-1/6/2022 when the Omicron was predominant (92%) and
63,203 infected between 9/1/2021-11/15/2021 when the Delta variant predominated.

They also matched 7,198 from each cohort to ensure they were equal in age, race/ethnicity, overall health, socioeconomic factors, and medications. Statistical parameters confirm that their findings are not random or by chance only.

Results: Omicron vs. Delta cases

The Omicron group was younger than the Delta group 1.49 vs. 1.73 years.
Both Delta and Omicron COVID-19 disproportionately infected Black children than other races, but there are more Blacks among Omicron cases.
Children with Omicron have fewer comorbidities.
Emergency room visits: 18.83% vs. 26.67%
Hospitalizations: 1.04% vs. 3.14%
Intensive Care Unit admissions within three days of infection: 0.14% vs. 0.43%
Mechanical ventilation: 0.33% vs. 1.15%

“Mortality risks were not reported in this study because so few deaths occurred within three days of infection in both cohorts.” according to the authors.

Bottom line: The risks for severe clinical outcomes in the Omicron cohort were
significantly lower than those in the Delta cohort.

The authors cautioned that because of the greater infectiousness of the Omicron variant, it wouldn’t be a surprise if more children under five would be seen by their doctors and need hospitalization. Fortunately, the vast majority will have a mild course. The research is a preprint and is available at medRxiv.

Omicron course is similar in adults.

Among adults, a study showed that the clinical course of Omicron is milder. Higher number of COVID-19 cases but no change in death rates. The South African omicron experience

COVID-19 in children are mild

It also confirms previous investigations among COVID-19 in children. Children 5-11 Years Old have Mild COVID-19 and COVID-19 in children 0-17 years old have a low risk of death and hospitalization.

A study showed that the mutations in the Omicron allowed it to be more infectious, but it has difficulty infecting the lung cells. Thus the clinical course is milder. Multinational study shows why the Omicron variant has low fatality and high infectivity.

The excellent news is Omicron infections elicit neutralizing antibodies against variants of concern like the Delta, Alpha, Beta, and the Wuhan strain. That immunity means protection in case those variants show up again. Asymptomatic or mild symptomatic COVID-19 elicits effective and long-lasting antibody responses in children and adolescents.

Should I be afraid of the omicron variant?

An article in this LINK is about COVID-19 in children. Call your children’s pediatrician if you have any concerns.

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Reference:

Wang et al. COVID infection severity in children under five years old before and after Omicron emergence in the US. medRxiv 2022.01.12.22269179; doi: https://doi.org/10.1101/2022.01.12.22269179

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