Comparison of COVID-19-associated inpatient burden by variant period in hospitalized children age <5 years…

Cohort studyFrontiers in pediatrics· 2025

Comparison of COVID-19-associated inpatient burden by variant period in hospitalized children age <5 years in the United States.

Kathleen M Andersen, Maria D McColgan, Alejandro Cane … Santiago M C Lopez

Pediatric Hospital MedicineCohort studyQ1IF 2.2

Omicron-era hospitalized children under 5 had similar oxygen supplementation needs as prior variants

Comparison of COVID-19-associated inpatient burden by variant period in hospitalized children age <5 years in the United States.

Kathleen M Andersen … Santiago M C Lopez

Frontiers in pediatrics · 2025 · Q1 in Pediatrics

Background

This study evaluated clinical outcomes in children aged <5 years with COVID-19-associated hospitalizations and assessed whether disease severity differed across periods of SARS-CoV-2 variant predominance in the United States.

Methods

Data from the PINC AI™ Healthcare Database during three distinct periods of SARS-CoV-2 variant predominance [pre-Delta (April 2021-June 2021), Delta (July 2021-December 2021), and Omicron (January 2022-July 2023)] were used.

n = 10,316 children

Results

similar share of hospitalized infants needed supplemental oxygen

13%

Pre-Delta oxygen

16%

Delta oxygen

18%

Omicron oxygen

More results

Overall, 10,316 children aged <5 years were hospitalized for COVID-19 over the three periods.

Most pediatric COVID-19 hospitalization occurred during the Omicron period.

In each time period, children aged <1 year were disproportionately affected.

For each outcome of interest, there were no statistically significant differences between variant periods.

“

Conclusion · 1 of 2

Despite perception that the omicron variant is less severe, children aged <5 years have a similar risk of severe COVID-19 as they did in earlier variant eras.

Conclusion · 2 of 2

These results highlight the need for continued preventative measures against severe COVID-19 in children, including routine immunization for eligible children and pregnant people with an updated COVID-19 vaccine.

Comparison of COVID-19-associated inpatient burden by variant period in hospitalized children age <5 years in the United States.

Comparison of COVID-19-associated inpatient burden by variant period in hospitalized children age <5 years in the United States.

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