SARS-CoV-2 Variants of Concern in Children and Adolescents: Insights from a Comprehensive Study

In the ongoing fight against the COVID-19 pandemic, understanding the impact of SARS-CoV-2 variants of concern (VOCs) is crucial, particularly in the context of children and adolescents. A recent study sought to answer five pivotal questions, shedding light on how these variants affect young individuals.

1. Symptoms and Severity: The study reveals that, in most cases, children with any VOC infection experienced mild symptoms. However, the Delta and Gamma VOCs were associated with more severe cases.

2. Risk Factors for Severe Disease: Throughout the pandemic, diabetes and obesity consistently emerged as risk factors for severe disease in young patients.

3. Risk of Infection: The risk of contracting a SARS-CoV-2 VOC appeared to increase with age, indicating the importance of age-related factors in infection susceptibility.

4. Risk of Transmission: Intriguingly, daycare settings showed that the risk of onward transmission of VOCs was higher among younger children compared to older children or partially vaccinated adults. These findings underscore the significance of targeting transmission prevention in specific age groups.

5. Long-Term Consequences: Long-term symptoms following an infection with a VOC were relatively rare, affecting less than 5% of children and adolescents.

Overall, the study suggests that the patterns of SARS-CoV-2 VOC infections in children and adolescents closely mirror those of earlier viral lineages. However, the researchers emphasize the need for more refined comparisons between different pandemic periods, countries, and age groups. This should be coupled with comprehensive reporting of relevant contextual factors, including VOC prevalence, vaccination status of study participants, and the population's risk of exposure to SARS-CoV-2.

Ref: Wiedenmann M, Ipekci AM, Araujo-Chaveron L, et alSARS-CoV-2 variants of concern in children and adolescents with COVID-19: a systematic review BMJ Open 2023;13:e072280. doi: 10.1136/bmjopen-2023-072280