{"doi":"10.1093/jpids/piac068","title":"Severity of Illness Caused by Severe Acute Respiratory Syndrome Coronavirus 2 Variants of Concern in Children: A Single-Center Retrospective Cohort Study","abstract":"BACKGROUND: Recent COVID-19 surges are attributed to emergence of more transmissible SARS-CoV-2 variants of concern (VOCs). The relative severity of VOCs in children is unknown. METHODS: We performed a single-center retrospective cohort study of children ≤18 years old diagnosed with COVID-19 from October 2020-February 2022 and whose SARS-CoV-2 isolate underwent Illumina sequencing. We measured the frequency of five markers of COVID-19 severity. Logistic regression models were fitted to estimate the odds of each severity marker with each VOC. RESULTS: Among 714 children, 471 (66.0%) were infected with a VOC: 96 (13.4%) alpha, 38 (5.3%) gamma, 119 (16.7%) delta, and 215 (30.1%) omicron. High-risk medical conditions and increasing age were independently associated with COVID-19 severity. After adjusting for age, race, ethnicity, high-risk medical conditions, and COVID-19 community incidence, neither alpha, delta, nor omicron was associated with severe COVID-19. Gamma was independently associated with hospitalization (OR 6.7, 95% CI 2.0-22.1); pharmacologic treatment (OR 5.7, 95% CI 1.2-26.8); respiratory support (OR 11.9, 95% CI 2.7-62.4); and severe disease per the WHO Clinical Progression Scale (OR 11.7, 95% CI 2.1-90.5). Upon subgroup analyses, omicron was independently associated with ICU admission and severe disease per the WHO Clinical Progression Scale in children without SARS-CoV-2 immunization or prior COVID-19 infection. CONCLUSIONS: Compared to non-VOC COVID-19, the gamma VOC was independently associated with increased COVID-19 severity, as was omicron in children without SARS-CoV-2 immunization or prior COVID-19 infection. SARS-CoV-2 vaccination and prior COVID-19 prevented severe outcomes during the omicron surge.","journal":"Journal of the Pediatric Infectious Diseases Society","year":2022,"id":250670,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":26,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7434,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":283126,"name":"Ramón Lorenzo-Redondo","orcid":"0000-0002-5462-9483","position":1,"is_corresponding":false},{"id":656140,"name":"Megan E. Reyna","orcid":null,"position":2,"is_corresponding":false},{"id":281228,"name":"Lacy M. Simons","orcid":"0000-0003-4041-6775","position":3,"is_corresponding":false},{"id":36741,"name":"Judd F. Hultquist","orcid":"0000-0001-6424-4280","position":4,"is_corresponding":false},{"id":724042,"name":"Ami B. Patel","orcid":"0000-0002-0626-4248","position":5,"is_corresponding":false},{"id":283133,"name":"Egon A. Ozer","orcid":"0000-0002-7131-3691","position":6,"is_corresponding":false},{"id":342568,"name":"William J. Muller","orcid":"0000-0001-7690-0695","position":7,"is_corresponding":false},{"id":679612,"name":"Taylor Heald‐Sargent","orcid":"0000-0003-0856-4006","position":8,"is_corresponding":false},{"id":233763,"name":"Matthew D. McHugh","orcid":"0000-0002-1263-0697","position":9,"is_corresponding":false},{"id":804369,"name":"Taylor J. Dean","orcid":"0009-0009-7557-3296","position":10,"is_corresponding":false},{"id":806539,"name":"Raj M Dalal","orcid":"0009-0002-0994-2662","position":11,"is_corresponding":false},{"id":806540,"name":"Jordan John","orcid":"0000-0003-4981-5748","position":12,"is_corresponding":false},{"id":807314,"name":"Shannon C. Manz","orcid":null,"position":13,"is_corresponding":false},{"id":388586,"name":"Larry K. Kociolek","orcid":"0000-0002-8756-3417","position":14,"is_corresponding":false},{"id":807313,"name":"Priya R. Edward","orcid":null,"position":0,"is_corresponding":true}],"reference_count":15,"raw_metadata":null,"created_at":"2026-07-19T00:24:32.960657Z","pmid":"35924454","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}