Data highlight greater impact of COVID-19 vs flu in young children
A study today in JAMA Network Open comparing COVID-19 versus flu in kids 5 years old and younger finds that the novel coronavirus led to twice the rate of admissions to pediatric intensive care units (PICUs) and rates of intubation one-third higher during the first 15 months of the pandemic.
The study included 1,561 US children with influenza from April 2018 to March 2020 and 1,959 children with SARS-CoV-2 infection or multisystem inflammatory syndrome in children (MIS-C) from April 2020 to June 2021, before the more severe Delta variant became dominant. Data were from 51 US PICUs, and all patients were under 6 years of age.
The pediatric researchers, from institutions across the country, found that COVID-19 admissions per quarter were twice as high as for flu—392 versus 195. The rate of endotracheal intubation was 33% higher with COVID—a median of 49 versus 36.9 instances per quarter. Mortality rates in the two groups were similar, but hospital and PICU stays were significantly longer for the children with COVID-19
The investigators noted that comorbidities did not change clinical outcomes substantially in either group.
The authors conclude, "Influenza outcomes were observed during a time with no unusual public health measures in place (2018 to early 2020), while those of SARS-CoV-2 occurred while masking, social distancing, and remote schooling occurred. Those measures were sufficient to markedly decrease critical illness from many respiratory viruses, including nearly eliminating influenza admissions to these PICUs.
"Without these measures in place for this largely unvaccinated population, SARS-CoV-2 would likely have led to a number of critically ill children several-fold higher than seen with prepandemic influenza as well as more deaths."
Jun 15 JAMA Netw Open study
Study shows antigen tests similar for Omicron as for previous variants
A new study based on COVID-19 tests performed on 723 Stanford University student-athletes showed rapid antigen tests (RAT) were highly specific when detecting infections caused by the Omicron variant, but displayed poor sensitivity compared to polymerase chain reaction (PCR) tests—similar to the results of previous SAR-CoV-2 variants. The study was also published today in JAMA Network Open.
The students used Binax Now tests from Jan 1 to Jan 11, 2022, when returning to campus after winter break. Forty-six participants (6.4%) had positive RAT findings, of whom 35 (76.1%) had symptomatic infections. Among the 35 symptomatic positive cases, 12 received a positive PCR result within 24 hours, and the remaining 23 were presumed to have positive results.
Twenty-seven students had a negative RAT followed by a positive RT-PCR result within 24 hours. In total 73 of 723 students had COVID-19, an infectivity rate of 10.1%.
The Binax RAT tests had a sensitivity of 63.0% (95% confidence interval [CI], 51.9% to 74.1% [46 of 73]) and specificity of 99.8% (95% CI, 99.5% to 100% [1 of 650]). Among symptomatic participants, RAT had a sensitivity of 77.8% (95% CI, 65.6% 89.9% [35 of 45]); among asymptomatic patients, it was only 39.2% (95% CI, 21.2%-57.4% [11 of 28]), the authors wrote.
"Rapid antigen testing performed similarly in the detection of the Omicron variant compared with previous variants, with high specificity but poor sensitivity, particularly among asymptomatic individuals. Its use as a screening tool for asymptomatic infection in the setting of widespread prevalence of the Omicron variant may be limited," the authors concluded.
Jun 15 JAMA Netw Open study