Serious Illness In Children More Likely With BA.2 Than Other Variants

Hong Kong achieved success in containing the coronavirus early on in the pandemic, but is now experiencing a surge and recorded its first pediatric COVID-19 deaths during the recent wave of infections caused by the BA.2 omicron variant. While only four deaths were reported, and the overall rate of serious illness in children was quite low, preliminary data indicates that BA.2 is significantly more likely to lead to ICU admission and death in children than other variants, influenza, or parainfluenza (a virus that causes croup).

“The intrinsic severity of Omicron BA.2 is not mild as evident by the fatality and severe complications of the uninfected and unvaccinated children,” said researchers in the preprint of the study released by medical journal The Lancet.

The study has not yet been peer-reviewed or published, and its results have not been replicated. However, the indication of an increase in serious illness with this variant underscores the need for more children to be vaccinated. Currently, only 27.3% of children ages 5 to 11 in the US are fully vaccinated, according to the CDC.

None of the children who died in Hong Kong were vaccinated, nor had they previously been infected with COVID-19. Their ages were 11 months and 3, 4, and 9 years. One of the children had a preexisting health condition (muscular dystrophy), and two of the children died of neurological complications.

Unfortunately, 1,147 children in Hong Kong were hospitalized with COVID-19 between Feb. 5 and Feb. 28 of this year, compared to a total of 737 who were hospitalized between Jan. 1, 2020 and Nov. 1, 2021. These numbers reflect both Hong Kong’s early success in preventing spread of the virus and the recent steep uptick in cases.

Children hospitalized with BA.2 were more likely to develop croup, have febrile seizures, be admitted to the pediatric ICU, and die than children hospitalized with previous variants, influenza, or parainfluenza.

Researchers found that the fatality rate among children infected with BA.2 was 0.35%. In comparison, the fatality rate for influenza was 0.05%, and 0.04% for parainfluenza. The death rate among children hospitalized with previous COVID-19 variants was zero.

Because coronavirus infection rates were so low in Hong Kong prior to the current BA.2 surge, it is difficult to determine how these findings might apply to the U.S.

“It's a little hard to know what that will look like here, where probably a large fraction of our population has been exposed at some point before either to Delta or BA.1,” Dr. Beth Thielen, a pediatric infectious disease specialist at the University of Minnesota in Minneapolis, told CNN.

Dr. Thielen also noted that treatment options for children are more limited than for adults.

Although the risk of COVID-19 infection in children remains low, it is sobering to learn of Hong Kong statistics. If you’ve been putting off vaccination for a 5- to 11-year-old child, now might be the time to book an appointment.