Evaluation of COVID-19 Pneumonia in Children According to the Original Strain, Alpha, Delta and Omicron Variants

Abstract

Objective: As known, COVID-19, stemming from the SARS-CoV-2 virus, exhibits distinct clinical patterns across various variants. This research endeavors to comprehensively analyze the variations in clinical presentations between these variants and the original strain, particularly in pediatric COVID-19 pneumonia cases. Materials and Methods: Patients diagnosed with COVID-19 pneumonia who were admitted to Mersin City Research and Training Hospital between June 2020-2022, were included in the study. Clinical and laboratory data of the patients were evaluated according to their variant status. Results: 56% (n=62) of 110 pediatric patients were female, and their average age was 11±5.9 (median 13). 31%(n=34) of the patients were infected with the original strain, 20% (n=22) were alpha, 40% (n=44) were delta, and 9% (n=10) were omicron variant. 6% (n=7) of the patients were asymptomatic, 11% (n=12) were mildly symptomatic, 76% (n=83) were moderate (respiratory distress), and 7% (n=8) were severe clinical patients requiring mechanical ventilation. Fever and shortness of breath were most frequently seen in delta, and cough in alpha variant (p=0.0001;p=0.014;p=0.039,respectively). The most severe disease detected in omicron was alpha, delta and original virüs (p=0.001). No relationship detected between the laboratory values of the patients and the variant status (p>0.05). When patients were compared based on radiological severity, no significant differences were found between the variants (p=0.214). However, when cases were classified according to pneumonia severity, regardless of the variant status, higher levels of ferritin (p=0.0001) and CRP (p=0.037) were observed, while lymphocyte count (p=0.009) decreased with increasing pneumonia severity. It's noteworthy that no patient fatalities occurred. Conclusion: In our study, the most severe clinical picture was shown in the omicron variant, followed by the alpha variant. But, omicron cases were limited, and it is important to examine variants in a larger population.