77 - Clinical outcomes in a cohort of pediatric COVID-19 patients by SARS-CoV-2 strain

Poster Number: 77
Publication Number: 77.106

Lauren M. Klingensmith, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Swati Goel, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Vinay Kampalath, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Keri Cohn, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

Background: The Delta variant of the SARS-CoV-2 virus was responsible for a surge in pediatric cases and hospital admissions across the United States during the summer of 2021. We sought to examine disease severity for children infected with the Delta variant, compared to ancestral strains.

Objective: We investigated the severity of clinical outcomes and effect of comorbidities on those outcomes among children with COVID-19 infection.

Design/Methods: This study evaluated two cohorts of patients, between March and December 2020, and September and October 2021, aged birth through 18 years, who tested positive for SARS-CoV-2 in the emergency department at a large urban academic children’s hospital. The 2021 cohort was identified based on the predominance of the Delta variant, confirmed by community genotyping. We used bivariate analyses with chi-square tests to evaluate odds of disease outcomes. Multivariate logistic regression was used to assess predictors of hospital admission.

Results: A sample of 918 patient charts were retrieved representing 563 patients who tested positive for ancestral strains and 355 for the Delta variant. The majority of patients were African American, non-Hispanic/Latino, and had public insurance. Bivariate analyses revealed no difference in hospital admission and disease severity outcomes between cohorts. When adjusted for sex, age, race, ethnicity, insurance type, ESI acuity score, and presence of any comorbidity, the Delta variant cohort had lower odds of hospital admission than the ancestral strain cohort (OR 0.8; 95% CI 0.51-1.23) but the result was not statistically significant. In the multivariable logistic regression analysis, patients with any comorbidity had increased odds of admission (OR 1.48; 95% CI 0.92- 2.40), but this result was not statistically significant.Conclusion(s): Severity of disease outcomes were similar in pediatric patients when comparing children infected with the ancestral and Delta variants of SARS-CoV-2, even among children with comorbidities. Further research is warranted as SARS-CoV-2 continues to evolve, including with the Omicron variant.
Lauren M. Klingensmith MD CVLMK CV 1-2022.pdf
Table 2: Clinical Outcomes by SARS-CoV-2 strain*Reported as N (%), unless otherwise noted. Cardiovascular support includes vasopressor requirement, ECMO, transfusions. Immune therapies includes antibiotics, antiviral medication, convalescent plasma. P-values < 0.05 were considered to represent statistical significance.