Marysville Appeal-Democrat

More kids were hit by upper airway infections during COVID omicron surge, studies show

- Tribune News Service Los Angeles Times

During the winter omicron surge, hospitaliz­ed coronaviru­spositive children were more likely to be hit with Covidrelat­ed upper airway infections than at other times of the pandemic, putting them at greater risk of severe disease, new data suggest.

One study found that the rate of upper airway infections — such as a type of bronchitis known as croup — among hospitaliz­ed coronaviru­s-infected children nearly tripled during the omicron era.

“Young children are especially vulnerable to (upper airway infection), given their small and relatively collapsibl­e airways,” according to the study, published recently in the journal JAMA Pediatrics.

More than 1 in 5 coronaviru­spositive children hospitaliz­ed with an upper airway infection developed severe disease, the report said.

“Children with severe (upper airway infection) are at risk of cardiac arrest from rapid-onset upper airway obstructio­n,” and may require treatment in an intensive care unit, such as sedation and the insertion of a breathing tube.

The report included nearly 19,000 children and teens younger than 19 with a positive coronaviru­s test who were hospitaliz­ed. In all, 384 had upper airway infections.

The study compared rates of upper airway infections in hospitaliz­ed children in the pre-omicron era, which the study defined as up through Christmas, and a snapshot of the early omicron era, from Dec. 26 through the end of January.

The study found about 1.5% of those hospitaliz­ed in the preomicron era developed upper airway infections. But in the omicron era, the rate climbed to 4.1%.

The latest estimate of the upper airway infection rate might actually be an underestim­ate, the report said, because children who were still hospitaliz­ed at the time the data were analyzed are not represente­d in the study.

Other data have shown that hospitaliz­ation rates among children 4 and younger rose to their highest rates of the entire pandemic during the omicron surge.

One report, published by the U.S. Centers for Disease Control and Prevention in March, shows that weekly COVID-19 hospitaliz­ation rates among children 4 and younger were five times as high during the peak of the omicron surge compared with delta.

For every 100,000 children in this age range, 14.5 were hospitaliz­ed for the week of omicron’s peak, compared to 2.9 during the week of delta’s peak.

When omicron dominated,

63% of hospitaliz­ed infants and children in this age group had no underlying medical conditions. Children in this age group — those 4 and younger — are ineligible for vaccinatio­ns.

“This is an illness that affects healthy children,” Dr. Mark Sawyer, a clinical pediatrics professor and pediatric infectious disease specialist at the University of California, San Diego School of Medicine and Rady Children’s Hospital San Diego, said in a recent briefing to the California Medical Associatio­n. “A lot of healthy kids get hospitaliz­ed.”

Unvaccinat­ed children are more likely to be hit hard by COVID-19, underlinin­g the importance of shots.

A study published by the

CDC said that COVID-19 hospitaliz­ation rates among 5- to 11-year-olds were twice as high among unvaccinat­ed children compared to those who were vaccinated.

“Thirty percent of hospitaliz­ed children had no underlying medical conditions, and 19% were admitted to an intensive care unit,” the report said. “Protect all eligible children by keeping vaccinatio­ns up to date.”

The primary reason for the increasing number of young children facing severe COVID-19 has to do with omicron being six to eight times more infectious than prior strains, which leads to higher rates of infections, said Dr. Robert Kim-farley, a professor and medical epidemiolo­gist with the UCLA Fielding School of Public Health.

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